Nursing Elites

1. Each statement is true regarding oral exposure to fermentable carbohydrates, except one. Which is the exception?

• A. Longer exposure leads to an increased risk of demineralization
• B. Longer exposure increases the opportunity for remineralization
• C. The Stephan curve illustrates pH changes within plaque after rinsing with a sugar solution
• D. The critical pH at which enamel decalcification occurs is 5.5 or less

Correct answer: B

Rationale: All the statements above are accurate about oral exposure to fermentable carbohydrates, except for option B. In fact, longer exposure to these carbohydrates decreases the opportunity for remineralization. This is because the process of demineralization, in which minerals are lost from the tooth enamel, is sped up by the presence of fermentable carbohydrates. The Stephan curve (option C) is a graph that demonstrates how the pH of dental plaque changes after a sugar rinse, usually dropping (becoming more acidic), which can lead to enamel decalcification. Option D is also accurate, as a pH of 5.5 or lower is the critical point at which enamel starts to decalcify.

2. A nurse is providing discharge teaching for a client who has acute pancreatitis and has a prescription for fat-soluble vitamin supplements. The nurse should instruct the client to take a supplement for which of the following?

• A. Vitamin A
• B. Vitamin B1
• C. Vitamin C
• D. Vitamin B12

Correct answer: A

Rationale: In acute pancreatitis, malabsorption of fat-soluble vitamins can occur due to pancreatic enzyme insufficiency. Vitamin A is a fat-soluble vitamin that may need supplementation in this case. Vitamin B1 (thiamine), Vitamin C, and Vitamin B12 are water-soluble vitamins and are not typically affected by pancreatic enzyme insufficiency in acute pancreatitis. Therefore, the correct supplement for the client with acute pancreatitis is Vitamin A.

3. Which of the following is the most important risk factor for development of Chronic Obstructive Pulmonary Disease?

• A. Cigarette smoking
• B. Occupational exposure
• C. Air pollution
• D. Genetic abnormalities

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

4. A client receiving continuous enteral tube feeding reports cramping and abdominal distention. Which of the following actions should the nurse take?

• A. Check for gastric residual.
• B. Apply low intermittent suction.
• C. Increase the rate of the feeding.
• D. Request a higher-fat formula.

Correct answer: A

Rationale: When a client on continuous enteral tube feeding experiences cramping and abdominal distention, the nurse should check for gastric residual. This assessment helps determine if the client is tolerating the feeding well or if there is a potential issue such as feeding intolerance. Applying low intermittent suction, increasing the feeding rate, or requesting a higher-fat formula are not appropriate actions for addressing the reported symptoms and may exacerbate the client's discomfort or lead to further complications.

5. The purpose of chest percussion and vibration is to loosen secretions in the lungs. The difference between the procedures is:

• A. Percussion uses only one hand, while vibration uses both hands
• B. Percussion delivers cushioned blows to the chest with cupped palms, while vibration gently shakes secretions loose
• C. In both percussion and vibration, the hands are not on top of each other, and hand action is not in tune with the client's breath
• D. Percussion slaps the chest to loosen secretions, while vibration shakes the secretions along with the inhalation

Correct answer: D

Rationale: Chest percussion involves the use of rhythmic tapping to dislodge mucus from the lungs, facilitating its movement toward the larger airways where it can be expelled. This technique is particularly important in conditions where mucus retention is a significant risk factor for infection. The key difference between chest percussion and vibration is that percussion involves slapping the chest to loosen secretions, while vibration involves shaking the secretions along with the inhalation, aiding in moving the loosened secretions upwards for easier removal. Choices A, B, and C do not accurately describe the main difference between chest percussion and vibration, making them incorrect.

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