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. Which breakfast items indicate an understanding of foods high in antioxidants A and C?

• A. Fried eggs, sausage, and whole wheat toast
• B. Oatmeal with blueberries and coffee
• C. Cereal with strawberries and low-fat milk
• D. Hard-boiled eggs, cantaloupe, and orange juice

Correct answer: D

Rationale: The correct answer is D: Hard-boiled eggs, cantaloupe, and orange juice. Cantaloupe and orange juice are rich in vitamins A and C, which are known for their antioxidant properties. Choice A is incorrect because fried eggs, sausage, and whole wheat toast do not contain high levels of antioxidants A and C. Choice B is incorrect because, while blueberries are high in antioxidants, coffee does not provide significant amounts of vitamins A and C. Choice C is incorrect because, although strawberries are a good source of vitamin C, low-fat milk does not contribute significantly to vitamins A and C.

3. The oral cavity is the site of a wide variety of systemic disease manifestations due to:

• A. Rapid cellular turnover
• B. Constant attack by microorganisms
• C. Trauma-intense environment
• D. All of the above

Correct answer: D

Rationale: The oral cavity is indeed the site of various systemic disease manifestations due to multiple factors. Firstly, the rapid cellular turnover in the oral mucosa makes it susceptible to diseases. Secondly, the constant presence of microorganisms in the oral cavity contributes to the development of systemic diseases. Finally, the oral cavity being a trauma-intense environment further increases the risk of systemic manifestations. Therefore, all the provided options - rapid cellular turnover, constant attack by microorganisms, and a trauma-intense environment - play a role in making the oral cavity a site for various systemic diseases. Hence, the correct answer is 'All of the above.' Choices A, B, and C are incorrect individually as they each represent only one aspect of why the oral cavity is prone to systemic disease manifestations, whereas the correct answer encompasses all these factors.

4. Which of the following is a common sign of vitamin D deficiency?

• A. Brittle nails
• B. Muscle weakness
• C. Night blindness
• D. Hair loss

Correct answer: B

Rationale: Muscle weakness is a common sign of vitamin D deficiency. Vitamin D is essential for calcium absorption and bone health, and its deficiency can lead to muscle weakness. Brittle nails (Choice A) are not typically associated with vitamin D deficiency. Night blindness (Choice C) is related to vitamin A deficiency, not vitamin D deficiency. Hair loss (Choice D) can be linked to various factors, but it is not a common sign of vitamin D deficiency.

5. Saturated fats are generally found in animal products with a few exceptions. Which of the following is a plant product that contains a large proportion of saturated fat?

• A. canola oil
• B. olive oil
• C. soybean oil
• D. coconut oil

Correct answer: D

Rationale: Coconut oil is a plant-based oil that is high in saturated fat, unlike most other plant oils, which are typically unsaturated.

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