Nursing Elites

1. In taking the client’s blood pressure, the nurse should position the client’s arm:

• A. At the level of the heart
• B. Slightly above the level of the heart
• C. At the 5th intercostals space midclavicular line
• D. Below the level of the heart

Correct answer: A

Rationale: Proper patient positioning is essential for maximizing lung expansion and promoting the drainage of secretions. Postural drainage techniques rely on gravity to help clear different lung segments, which is critical in preventing complications such as atelectasis or pneumonia in immobilized patients.

2. A nurse is teaching about nutrition to a client who has a new diagnosis of chronic kidney disease. Which of the following recommendations should the nurse include in the teaching?

• A. Increase phosphorus intake
• B. Limit calcium intake
• C. Limit protein intake
• D. Increase potassium intake

Correct answer: C

Rationale: The correct recommendation for a client with chronic kidney disease is to limit protein intake. Excessive protein consumption can strain the kidneys as they work to eliminate waste products from protein metabolism. This can worsen kidney function in individuals with chronic kidney disease. Therefore, limiting protein intake is crucial in managing this condition. Choices A, B, and D are incorrect. Increasing phosphorus intake can be harmful in kidney disease as it can lead to mineral imbalances. Limiting calcium intake is not typically necessary unless the client has specific complications. Increasing potassium intake may also be inappropriate as potassium levels can be affected in kidney disease.

3. 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.

4. Reducing the amount of trans fat in the diet is an effective method of decreasing the risk of CHD. Which food is most likely a source of trans fat?

• A. hot dogs
• B. whole milk
• C. fatty fish
• D. potato chips

Correct answer: D

Rationale: The correct answer is D: potato chips. Potato chips, especially when fried in hydrogenated oils, are a common source of trans fats, which are linked to an increased risk of coronary heart disease (CHD). Hot dogs (choice A) can also contain trans fats if made with processed meats and added fats. Whole milk (choice B) and fatty fish (choice C) do not typically contain trans fats, making them less likely sources compared to potato chips.

5. How many words does a typical 12-month-old infant use?

• A. About 12 words
• B. Twenty or more words
• C. About 50 words
• D. Two, plus 'mama' and 'papa'

Correct answer: D

Rationale: A typical 12-month-old infant typically uses very few words, with 'mama' and 'papa' being common early words. At this age, most infants are still in the early stages of language development, and their vocabulary is limited. Choices A, B, and C suggest higher word counts which are not typical for infants at this age.

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