Nursing Elites

1. Theresa, a mother with a 2-year-old daughter, asks, 'At what age can I start taking my daughter's blood pressure as a routine procedure, since hypertension is common in our family?' What would your answer be?

• A. At 2 years old, you may
• B. As early as 1 year old
• C. When she's 3 years old
• D. When she's 6 years old

Correct answer: D

Rationale: Regular blood pressure checks generally start from age 3, but in the case of a family history of hypertension, they should start when the child is around 6 years old. This is because the readings will be more reliable and indicative of the child's health condition at this age. The other options are incorrect because they suggest earlier ages for routine blood pressure checks. While blood pressure can be measured at any age, it is not typically included as part of a routine health check-up for very young children unless there are specific health concerns.

2. A patient with an ileostomy is suffering from frequent diarrhea. The clinician should advise the patient to increase his intake of what food to thicken stool output?

• A. celery
• B. salad greens
• C. potatoes
• D. dried beans and peas

Correct answer: C

Rationale: Potatoes are starchy and can help thicken stool output, making them beneficial for patients with an ileostomy experiencing diarrhea.

3. Each statement is true of swallowing and processing food, except one. Which is the exception?

• A. The swallowing reflex moves a bolus into the esophagus
• B. A bolus is a mass of food
• C. The bolus is transported to the stomach by osmosis and gravity
• D. The bolus penetrates the diaphragm through the esophageal hiatus

Correct answer: C

Rationale: The correct answer is C. The bolus is not transported to the stomach by osmosis and gravity, but by peristalsis. Peristalsis is the involuntary constriction and relaxation of muscles to push the bolus through the digestive system. Choices A, B, and D are correct statements. A bolus is indeed a mass of food, the swallowing reflex does move the bolus into the esophagus, and the bolus does not penetrate the diaphragm through the esophageal hiatus; instead, it enters the stomach through the lower esophageal sphincter.

4. A client is on a 2,000-calorie American Diabetes Association (ADA) diet and substitutes whole milk with skim milk. Which of the following items can the client add to the oatmeal on his breakfast tray?

• A. One 1/8 teaspoon of salt
• B. One ounce of raisins
• C. One tablespoon of low-fat margarine
• D. One teaspoon of brown sugar

Correct answer: B

Rationale: The correct answer is one ounce of raisins. Raisins are a healthy option to add to oatmeal as they provide natural sweetness without added sugars. They are a good source of fiber and essential nutrients. Option A, one 1/8 teaspoon of salt, is not necessary for flavoring oatmeal. Option C, one tablespoon of low-fat margarine, may add unnecessary fat to the meal. Option D, one teaspoon of brown sugar, adds extra sugar, which should be limited in a diabetes-friendly diet.

5. By the age of three, which age-appropriate food skill can a child typically perform?

• A. Using utensils and a napkin
• B. Spearing food with a fork
• C. Measuring liquids
• D. Displaying proper table manners

Correct answer: B

Rationale: By the age of three, a child typically develops the motor skills needed to spear food with a fork. This is a critical milestone in self-feeding as it shows progress in fine motor coordination. Choice 'A' is incorrect because using utensils and a napkin properly is a skill that may take longer to develop and refine. Choice 'C' is not correct as measuring liquids requires a higher level of motor skills and understanding of quantities that a three-year-old child might not possess. Choice 'D' is also incorrect as the proper display of table manners is a complex skill that is typically learned over a longer period and involves social and cultural norms.

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