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. Which nutrients might people who follow a vegan diet be deficient in?

• A. Vitamin B12
• B. Vitamin C
• C. Vitamins A and D
• D. Calcium

Correct answer: C

Rationale: People who adhere to a vegan diet might indeed be deficient in vitamins A and D, which are primarily found in animal-derived foods. While vitamin B12 and calcium can also be lacking in a vegan diet, these were not choices given that would correctly answer the question. Vitamin C, on the other hand, is widely available in numerous plant-based foods, making it less likely for vegans to be deficient in it. Therefore, the correct answer is 'Vitamins A and D'. It's important to note that deficiencies can be avoided through careful meal planning or supplementation.

3. Which of the following suggestions is the healthiest for Miguel, who is always hungry and never seems to feel full despite eating enough calories?

• A. Switch out energy-dense foods with more nutrient-dense foods that are more likely to make him feel full
• B. Drink adequate amounts of water
• C. A, B
• D. Eat foods with more fat, as fat slows gastric emptying and will make him feel more full

Correct answer: C

Rationale: The correct answer is A and B. Switching to more nutrient-dense foods can help Miguel feel full despite eating enough calories. Nutrient-dense foods provide essential nutrients and are more satisfying. Drinking adequate water is also crucial for overall health and can help with feelings of fullness. Choice D is incorrect because while fat can contribute to satiety, it should be consumed in balance with other nutrients. Consuming foods with high fat content excessively may lead to other health issues and does not address the underlying problem of feeling constantly hungry despite eating.

4. Nancy blames God for her situation. She is easily provoked to tears and wants to be left alone, refusing to eat or talk to her family. A religious person before, she now refuses to pray or go to church stating that God has abandoned her. The nurse understands that Nancy is grieving for her self and is in the stage of:

• A. bargaining
• B. denial
• C. anger
• D. acceptance

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

5. Medication for treating high blood cholesterol levels should not be used for most people unless:

• A. The patient has at least three major risk factors for coronary heart disease
• B. The patient has been experiencing symptoms of coronary heart disease for at least three months
• C. The patient's medical insurance covers prescription drugs
• D. Treatment with Therapeutic Lifestyle Changes (TLC) alone is unsuccessful after three months

Correct answer: D

Rationale: The correct answer is choice D because medication for high cholesterol is typically not considered unless Therapeutic Lifestyle Changes (TLC), which include diet and exercise, have not proven effective after a three-month period. This approach ensures that lifestyle modifications are given a fair chance to lower cholesterol levels before resorting to medication. Choice A is incorrect because the number of risk factors for coronary heart disease does not dictate when to begin medication; it is about the effectiveness of lifestyle changes. Choice B is incorrect as the duration of coronary heart disease symptoms does not determine when to start medication; the focus is on the response to TLC. Choice C is incorrect because the coverage of prescription drugs by the patient's insurance does not influence the medical decision to use medication for high cholesterol; it is based on medical necessity and effectiveness of prior interventions.

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