Nursing Elites

1. Mario listens to Richard’s bilateral sounds and finds that congestion is in the upper lobes of the lungs. The appropriate position to drain the anterior and posterior apical segments of the lungs when Mario does percussion would be:

• A. Client lying on his back then flat on his abdomen on Trendelenburg position
• B. Client seated upright in bed or on a chair then leaning forward in sitting position then flat on his back and on his
• C. Client lying flat on his back and then flat on his abdomen
• D. Client lying on his right then left side on Trendelenburg position

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. The PEM in which children ages 18-24 months display edema of the extremities, torso, and face, fatty liver, sparse yellow hair, and receive adequate kilocalories but not enough high-quality proteins is called?

• A. Marasmus
• B. Kwashiorkor
• C. Anemia
• D. Noma

Correct answer: B

Rationale: Kwashiorkor is a form of severe malnutrition characterized by edema, fatty liver, and other symptoms, typically resulting from inadequate protein intake despite adequate calorie intake.

3. Which statement about essential nutrients should the nurse include?

• A. Fat-containing foods can help to decrease triglyceride levels.
• B. Animal sources of protein contain 20 essential amino acids.
• C. Carbohydrates are the primary source of fuel for muscles and the brain.
• D. High-fiber foods are a good source of energy.

Correct answer: C

Rationale: The correct answer is C because carbohydrates are indeed the primary source of fuel for muscles and the brain. Choice A is incorrect because while certain fats are essential, they do not help decrease triglyceride levels. Choice B is incorrect because animal sources of protein do not contain all 20 essential amino acids. Choice D is incorrect because although high-fiber foods are important for digestion and overall health, they are not a direct source of energy.

4. What nutrition-related side effect is most likely to occur after head and neck surgery for cancer treatment?

• A. Aspiration
• B. Acid reflux
• C. Dumping syndrome
• D. Diarrhea

Correct answer: A

Rationale: The most likely nutrition-related side effect after head and neck surgery for cancer treatment is aspiration. This is due to changes in swallowing mechanics, which can cause food or liquids to be inhaled into the lungs. While acid reflux, dumping syndrome, and diarrhea are potential side effects related to nutrition, they are not as directly connected to head and neck surgery. Acid reflux is more often related to issues with the lower esophageal sphincter, dumping syndrome is typically a complication of gastric surgery, and diarrhea can have various causes, including certain medications or gastrointestinal illnesses.

5. A nurse is planning care for a toddler who has burns over 50% total body surface area. Which of the following actions should the nurse include in the plan of care?

• A. Administer enteral feedings
• B. Limit intake of vitamin C
• C. Limit dietary protein
• D. Administer insulin prior to meals

Correct answer: A

Rationale: Administering enteral feedings is crucial for ensuring adequate nutrition and supporting healing in toddlers with extensive burns. Burns over 50% total body surface area can lead to increased metabolic demands, making it essential to provide nutrition through enteral feedings to meet the child's needs for healing and recovery. Limiting intake of vitamin C or dietary protein would be detrimental in this scenario as the child requires increased amounts of nutrients to support healing. Administering insulin prior to meals is not indicated in this case as the priority is to provide adequate nutrition to promote healing.

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