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. While a team effort is necessary in the operating room (OR) for efficient and quality patient care delivery, the number of people in the room should be limited for infection control purposes. Which roles comprise this team?

• A. Surgeon, anesthesiologist, scrub nurse, radiologist, orderly
• B. Surgeon, assistants, scrub nurse, circulating nurse, anesthesiologist
• C. Surgeon, assistant surgeon, anesthesiologist, scrub nurse, pathologist
• D. Surgeon, assistant surgeon, anesthesiologist, intern, scrub nurse

Correct answer: B

Rationale: The roles typically present in an operating room team include the surgeon, assistants (which may include an assistant surgeon), scrub nurse, circulating nurse, and anesthesiologist. These roles are directly involved in the operation and patient care. Choice B is correct. Choice A includes a radiologist and an orderly, who are not typically part of the immediate surgical team in the OR. Choice C includes a pathologist, who usually works in a laboratory outside of the OR. Choice D includes an intern, who may or may not be part of the team, depending on the specific circumstances and hospital policy. These explanations make choices A, C, and D incorrect.

3. The purpose of the health history is to identify health-related considerations and medications that may cause nutritional risk. Many medications, such as prednisone, have drug-nutrient interactions that can influence nutrient needs.

• 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: A

Rationale: Both statements are true. The health history aims to uncover health-related factors that could pose nutritional risks, including medications like prednisone that may have interactions affecting nutrient requirements. Choice B is incorrect as both statements are accurate, emphasizing the significance of health history in assessing nutritional concerns.

4. Which factor has been shown to increase the risk of development of atherosclerosis?

• A. Menopause
• B. Age older than 35
• C. Increased levels of arachidonic acid
• D. Elevated HDL cholesterol

Correct answer: A

Rationale: The correct answer is A: Menopause. Menopause is associated with an increased risk of atherosclerosis due to hormonal changes that affect lipid profiles and vascular health. Conversely, B: Age older than 35 is not necessarily a risk factor for atherosclerosis on its own, though atherosclerosis risk does generally increase with age. C: Increased levels of arachidonic acid is not specifically linked to atherosclerosis; it's a fatty acid that can be both beneficial and harmful to health depending on its metabolic pathway. D: Elevated HDL cholesterol is actually beneficial rather than harmful because HDL cholesterol is known as 'good' cholesterol that helps to reduce the risk of heart disease and atherosclerosis.

5. Which cells in the islet of the pancreas are responsible for synthesizing insulin?

• A. Alpha cells
• B. Beta cells
• C. Gamma cells
• D. Delta cells

Correct answer: B

Rationale: Beta cells in the islets of Langerhans in the pancreas are responsible for the production and secretion of insulin, which is crucial for regulating blood glucose levels. Alpha cells, on the other hand, produce glucagon, a hormone that raises blood glucose levels. Gamma cells and Delta cells do not exist in the islets of Langerhans; therefore, they are incorrect choices.

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