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 is the most common nutritional disorder for the older adult?

• A. Obesity
• B. Underweight
• C. Vitamin deficiency
• D. Dehydration

Correct answer: A

Rationale: The correct answer is A: Obesity. Among older adults, obesity is the most common nutritional disorder. This is often attributed to reduced physical activity levels and changes in metabolism that occur with aging. Choice B (Underweight) is less common among older adults as compared to obesity. While choices C (Vitamin deficiency) and D (Dehydration) are important nutritional issues, they are generally not as prevalent as obesity in the older adult population.

3. A nurse is providing teaching about formula feeding to the parents of an infant. Which of the following instructions should the nurse include?

• A. Formula that remains in the bottle should not be used for one more feeding.
• B. Formula should be changed to whole milk when the infant is 12 months old.
• C. If the infant is gaining weight too rapidly, do not dilute the formula.
• D. If the infant turns away after taking most of the feeding, stop the feeding.

Correct answer: D

Rationale: If the infant turns away after taking most of the feeding, it indicates they are full, and continuing to feed may lead to overfeeding. Choice A is incorrect because it is not safe to use formula that remains in the bottle for another feeding due to the risk of bacterial contamination. Choice B is incorrect as whole milk should be introduced after the infant is 12 months old, not 9 months old. Choice C is incorrect as diluting formula can compromise the infant's nutrition and should not be done without healthcare provider guidance.

4. A client with a history of pancreatitis is being taught by a nurse. Which of the following food choices should the nurse instruct the client to avoid?

• A. Noodles
• B. Vegetable Soup
• C. Baked Fish
• D. Cheddar cheese

Correct answer: D

Rationale: Patients with pancreatitis should avoid high-fat foods like cheddar cheese as they can exacerbate symptoms due to the organ's role in fat digestion. Noodles, vegetable soup, and baked fish are generally considered to be lower in fat content and are thus safer choices for individuals with pancreatitis.

5. Which type of medication is most likely to induce xerostomia?

• A. Antibiotics
• B. Diuretics
• C. Local anesthetics
• D. Anticholinergics

Correct answer: D

Rationale: The correct answer is D, Anticholinergics. Anticholinergic medications commonly cause xerostomia by inhibiting saliva production, leading to dry mouth. Antibiotics (choice A) are not typically associated with xerostomia. Diuretics (choice B) increase urine production but do not directly affect saliva production. Local anesthetics (choice C) are used to numb specific areas during dental procedures and do not induce xerostomia.

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