Nursing Elites

1. 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.

2. What would you do to increase the amount of iron absorbed from a meal?

• A. Drink plenty of coffee before each meal
• B. Avoid eating foods rich in vitamin C with the meal
• C. Eat a calcium-rich food with the meal
• D. Consume orange juice as a beverage with a meal

Correct answer: D

Rationale: The correct answer is D: 'Consume orange juice as a beverage with a meal'. This is because Vitamin C significantly enhances the absorption of non-heme iron, a form of iron found in plant-based foods. Therefore, consuming orange juice, which is rich in vitamin C, with a meal can effectively increase iron absorption. On the contrary, choices A, B, and C are incorrect. Coffee (Choice A) contains polyphenols that can inhibit iron absorption. Avoiding vitamin C-rich foods (Choice B) would decrease iron absorption, not increase it. While calcium (Choice C) is essential for many bodily processes, it can actually inhibit iron absorption when consumed together.

3. Which of the following statements is correct about MyPlate?

• A. Canned fruit can be considered part of the fruit group
• B. Soymilk is considered part of the dairy group
• C. Beans and peas are considered part of both the protein group and the vegetable group
• D. Cream cheese and butter are not part of the dairy group

Correct answer: C

Rationale: According to the MyPlate guide, beans and peas are classified as part of both the protein and vegetable groups due to their high protein content and the nutrients they share with vegetables. This makes Choice C correct. Choice A is incorrect as canned fruit can be part of the fruit group if it's canned in water or 100% fruit juice. Soymilk is considered part of the dairy group, making Choice B incorrect. While cream cheese and butter are dairy products, they are not part of the dairy group on MyPlate because they contain little to no calcium, making Choice D incorrect.

4. Children with cerebral palsy, Down syndrome, and intellectual disabilities are likely to have abnormal sensory input and muscle tone. A small, underdeveloped tongue is common in many such disorders and results in diminished nutritional status.

• 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, but the second is false. These children often have a large tongue or tongue thrust, which can interfere with feeding and nutrition.

5. What is the first thing you should do before sharing information with a patient?

• A. Provide background knowledge
• B. Ask for permission
• C. Remove personal protective equipment (PPE)
• D. Remind the patient that you are the authority

Correct answer: B

Rationale: Before sharing information with a patient, it is essential to ask for their permission. This action respects the patient's autonomy and encourages their participation in the learning process. Asking for permission establishes a foundation of trust and partnership between the healthcare provider and the patient. Providing background knowledge (Choice A) is important, but it should come after receiving consent to share information. Removing personal protective equipment (Choice C) is not related to the communication process. Reminding the patient that you are the authority (Choice D) is inappropriate as it can undermine the patient's autonomy and hinder effective communication in a patient-centered care approach.

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