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. Toilet training occurs in the anal stage of Freud’s psychosexual development. This is equivalent to Erikson’s:

• A. Trust vs. Mistrust
• B. Autonomy vs. Shame and Doubt
• C. Initiative vs. Guilt
• D. Industry vs. Inferiority

Correct answer: A

Rationale: The correct answer is A: Trust vs. Mistrust. In Freud's psychosexual development theory, the anal stage is where toilet training occurs, focusing on issues of control and independence. This stage is parallel to Erikson's Trust vs. Mistrust stage, where infants learn to trust or mistrust their caregivers based on the consistency of care they receive. Choices B, C, and D are incorrect as they correspond to different stages in Erikson's psychosocial development theory, not related to toilet training or the anal stage of Freud's theory.

3. Which vitamin is crucial for collagen synthesis and wound healing?

• A. Vitamin C
• B. Vitamin D
• C. Vitamin E
• D. Vitamin K

Correct answer: A

Rationale: The correct answer is Vitamin C. Vitamin C is crucial for collagen synthesis, a process important for wound healing. Collagen is a key protein that helps in wound repair and tissue strength. Vitamin D is primarily known for its role in calcium absorption and bone health, not directly related to collagen synthesis. Vitamin E is an antioxidant that helps protect cells from damage but is not directly involved in collagen synthesis. Vitamin K is essential for blood clotting but does not play a major role in collagen synthesis for wound healing.

4. The stages of grieving identified by Elizabeth Kubler-Ross are:

• A. Numbness, anger, resolution and reorganization
• B. Denial, anger, identification, depression and acceptance
• C. Anger, loneliness, depression and resolution
• D. Denial, anger, bargaining, depression and acceptance

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.

5. Knowing that for a comatose patient hearing is the last sense to be lost, as Judy’s nurse, what should you do?

• A. Tell her family that probably she can’t hear them
• B. Talk loudly so that Wendy can hear you
• C. Tell her family who are in the room not to talk
• D. Speak softly then hold her hands gently

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

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