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. Dental hygienists should not encourage patients with eating disorders such as bulimia to brush immediately after vomiting because self-induced vomiting causes erosion of tooth enamel and dentin hypersensitivity.

• A. Both the statement and the reason are correct and related
• B. Both the statement and the reason are correct but are not related
• C. The statement is correct, but the reason is not correct
• D. The statement is not correct, but the reason is correct

Correct answer: D

Rationale: The corrected question emphasizes that patients with eating disorders like bulimia should not brush immediately after vomiting as it can worsen enamel erosion due to the acidic content in the mouth. The correct answer is D because patients should rinse with water or a fluoride mouthwash instead of brushing to protect their teeth. Choice A is incorrect because encouraging patients to brush after vomiting is not recommended. Choice B is incorrect as the reason provided is valid but not suitable for the action of encouraging brushing. Choice C is incorrect as the reason for not brushing after vomiting is to prevent enamel erosion.

3. Which of the following is a good food source of iodine?

• A. Seafood
• B. Lettuce
• C. Broccoli
• D. Pork

Correct answer: A

Rationale: Seafood is a rich source of iodine, essential for maintaining healthy thyroid function and overall metabolic health. While lettuce, broccoli, and pork may contain some iodine, they do not provide as substantial an amount as seafood. Therefore, they are not considered 'good' sources of iodine in comparison.

4. Dietary fiber has been recommended for its possible benefits in reducing heart disease by lowering blood cholesterol. How is fiber thought to play its role in lowering blood cholesterol?

• A. Insoluble fiber binds with cholesterol in the large intestine and is excreted in feces
• B. Viscous fiber binds with bile in the intestine and is excreted in feces
• C. Soluble fiber binds with cholesterol in the blood and is excreted by the liver
• D. Insoluble fiber converts to bile in the large intestine and binds with cholesterol

Correct answer: B

Rationale: The correct answer is B. Viscous (soluble) fiber binds with bile acids in the intestine, which are then excreted. The liver must use cholesterol to make more bile acids, thereby lowering blood cholesterol levels. Choice A is incorrect as insoluble fiber does not bind with cholesterol in the large intestine. Choice C is incorrect as soluble fiber does not directly bind with cholesterol in the blood. Choice D is incorrect as insoluble fiber does not convert to bile in the large intestine to bind with cholesterol.

5. A client who is 2 days postoperative following abdominal surgery is about to progress from a clear liquid diet to full liquids. Which of the following items should the nurse tell the client he may now request to have on his meal tray?

• A. Cranberry juice
• B. Flavored gelatin
• C. Skim milk
• D. Chicken broth

Correct answer: A

Rationale: Cranberry juice is an appropriate choice for a client transitioning from a clear liquid diet to full liquids post abdominal surgery. It provides hydration and some essential nutrients. Flavored gelatin is usually allowed on a clear liquid diet and may not be suitable for a full liquids phase. Skim milk and chicken broth are typically introduced in a later stage of the diet progression, closer to a soft diet, due to their higher protein and fat content.

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