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. A patient is on a low-sodium diet. Which food item should the patient avoid?

• A. Fresh fruit
• B. Canned soup
• C. Whole grain bread
• D. Grilled chicken

Correct answer: B

Rationale: The correct answer is B: Canned soup. Canned soup is commonly high in sodium content, which is not suitable for a patient on a low-sodium diet. Fresh fruit, whole grain bread, and grilled chicken typically have lower sodium levels and can be included in a low-sodium diet. Therefore, the patient should avoid canned soup to adhere to the requirements of a low-sodium diet.

3. During nutritional counseling, what is the most important step to take?

• A. Consult the patient's family
• B. Formulate a sample diet plan before presenting it to the patient
• C. Include members of the dental team in the dietary formulation
• D. Include the patient in the formulation of the dietary plan

Correct answer: D

Rationale: During nutritional counseling, the most important step is to include the patient in the formulation of the dietary plan. This ensures their active involvement, understanding, and commitment to the plan, leading to better compliance and success in achieving nutritional goals. Consulting the patient's family (Choice A) may be helpful but should not replace involving the patient directly. Formulating a sample diet plan before presenting it to the patient (Choice B) may not align with the patient's preferences or needs. Including members of the dental team in the dietary formulation (Choice C) may not be necessary unless specific dental concerns need to be addressed.

4. Symptoms of irritable bowel syndrome are most likely associated with disturbed defecation, bloating, and _____.

• A. rectal bleeding
• B. abdominal pain
• C. rectal fissures
• D. esophageal paralysis

Correct answer: B

Rationale: Abdominal pain is a common symptom of irritable bowel syndrome (IBS), along with bloating and changes in bowel habits. Rectal bleeding (choice A) is more commonly associated with conditions like inflammatory bowel disease or colorectal cancer. Rectal fissures (choice C) may cause rectal bleeding but are not typically considered a core symptom of IBS. Esophageal paralysis (choice D) is unrelated to the symptoms of IBS, which primarily affect the lower gastrointestinal tract.

5. How many diet-related major risk factors for coronary heart disease does Mrs. Winslow have?

• A. 1
• B. 4
• C. 2
• D. 3

Correct answer: B

Rationale: Mrs. Winslow has four major diet-related risk factors for coronary heart disease: high total cholesterol, high LDL cholesterol, high triglycerides, and low HDL cholesterol. Choice A is incorrect because there are more than one risk factor present. Choices C and D are incorrect as they do not account for the total number of diet-related major risk factors identified.

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