Nursing Elites

1. Instruction on health promotion regarding urinary elimination is important. Which would you include?

• A. Hold urine as long as possible before emptying the bladder to strengthen the sphincter muscles
• B. If a burning sensation is experienced while voiding, drink water
• C. After urination, wipe from the anal area towards the pubis
• D. Tell the client to empty the bladder at each voiding

Correct answer: D

Rationale: The correct answer is to instruct the client to empty the bladder at each voiding. This is essential to prevent urinary retention and reduce the risk of urinary tract infections. Choice A is incorrect because holding urine for prolonged periods can lead to urinary retention and increase the risk of infections. Choice B is incorrect as pineapple juice can exacerbate a burning sensation due to its acidity; the correct approach is to drink water to dilute the urine. Choice C is incorrect as wiping from the anal area towards the pubis can introduce bacteria into the urinary tract, potentially causing infections.

2. 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.

3. Of the foods listed, the best source of phosphorus is?

• A. lettuce
• B. pears
• C. chicken
• D. noodles

Correct answer: C

Rationale: Chicken is a good source of phosphorus, which is essential for bone health and energy production in the body.

4. A group of clients is being instructed by a nurse regarding nutrition. The teaching should state that which of the following groups of foods contains the highest level of carbohydrates?

• A. Milk, eggs, and cheese
• B. Butter, oils, and avocados
• C. Rice, potatoes, and oranges
• D. Chicken, green beans, and apples

Correct answer: C

Rationale: The correct answer is C: Rice, potatoes, and oranges. These foods are rich in carbohydrates. Choice A (Milk, eggs, and cheese) contains minimal carbohydrates as they are primarily sources of protein and fat. Choice B (Butter, oils, and avocados) contains very little to no carbohydrates as they are high in fats. Choice D (Chicken, green beans, and apples) also contains minimal carbohydrates, with protein and fiber being more prominent in these foods.

5. While on Bryant’s traction, which of these observations of Graciela and her traction apparatus would indicate a decrease in the effectiveness of her traction?

• A. Graciela’s buttocks are resting on the bed.
• B. The traction weights are hanging 10 inches above the floor.
• C. Graciela’s legs are suspended at a 90 degree angle to her trunk.
• D. The traction ropes move freely through the pulley.

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

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