Nursing Elites

1. The nurse is working with a patient who recently had a stroke. The patient frequently chokes and coughs when eating and is having difficulty feeding herself. What is the best way to ensure adequate nutrition?

• A. to have an aide feed her at each meal
• B. to ask a family member to assist during meals
• C. to provide tube feedings for the patient
• D. to initiate TPN for the patient

Correct answer: C

Rationale: The best way to ensure adequate nutrition for a stroke patient who frequently chokes and coughs when eating and has difficulty feeding herself is to provide tube feedings. Tube feedings are a safe and effective method to deliver nutrition directly to the stomach or intestines, bypassing the swallowing mechanism, reducing the risk of aspiration. Having an aide feed her each meal (choice A) may not address the underlying issue of swallowing difficulty and aspiration risk. Asking a family member to be present at each meal (choice B) does not provide a definitive solution to the patient's nutritional needs. Placing the patient on total parenteral nutrition (TPN) (choice D) is a more invasive and typically reserved for patients who cannot tolerate enteral feedings or have non-functional gastrointestinal tracts.

2. Where does carbohydrate digestion begin?

• A. Mouth
• B. Esophagus
• C. Stomach
• D. Small intestine

Correct answer: A

Rationale: Carbohydrate digestion begins in the mouth. The enzyme amylase, found in saliva, starts the process by breaking down starches into sugars. The esophagus is a passageway for food to reach the stomach and does not participate in digestion. The stomach mainly digests proteins and is not the primary site for carbohydrate breakdown. While the small intestine does play a crucial role in digesting carbohydrates, it is not where the process initiates. Therefore, the correct answer is the mouth.

3. The correct temperature to store vaccines in a refrigerator is:

• A. between -4 deg C and +8 deg C
• B. between 2 deg C and +8 deg C
• C. between -8 deg C and 0 deg C
• D. between -8 deg C and +4 deg C

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

4. Mr. Bruno asks what the “normal” allowable salt intake is. Your best response to Mr. Bruno is:

• A. 1 tsp of salt/day with iodine and sprinkle of MSG
• B. 5 gms per day or 1 tsp of table salt/day
• C. 1 tbsp of salt/day with some patis and toyo
• D. 1 tsp of salt/day but no patis and toyo

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

5. Nonnutritive sweeteners are not metabolized by microorganisms and do not promote dental caries. Products made with a nonnutritive sweetener can be used as frequently as 8 to 10 times per day.

• A. Both statements are true
• B. Both statements are false
• C. The first statement is true; the second is false
• D. The first statement is false; the second is true

Correct answer: C

Rationale: The first statement is true; nonnutritive sweeteners do not promote caries. However, the second statement is false because products with nonnutritive sweeteners should still be consumed in moderation.

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