Nursing Elites

1. Tony is to be discharged in the afternoon of the same day after tonsillectomy and adenoidectomy. You, as the RN, will make sure that the family knows to:

• A. offer pureed foods
• B. offer soft foods for a week to minimize discomfort while swallowing
• C. supplement his diet with Vitamin C-rich foods to enhance healing
• D. offer clear liquids for 3 days to prevent irritation

Correct answer: B

Rationale: After tonsillectomy and adenoidectomy, it is crucial to provide soft foods for a week to minimize discomfort while swallowing. This helps prevent irritation to the surgical site and allows for easier healing. Offering pureed foods (Choice A) may not be necessary as soft foods are usually sufficient. While Vitamin C is beneficial for healing, it is not necessary to supplement it immediately after surgery with Vitamin C-rich juices (Choice C). Clear liquids are typically recommended before surgery and not after, as the focus shifts to soft foods to aid in recovery, making Choice D incorrect.

2. Mrs. Pichay who is for thoracentesis is assigned by the nurse to any of the following positions, EXCEPT:

• A. straddling a chair with arms and head resting on the back of the chair
• B. lying on the unaffected side with the bed elevated 30-40 degrees
• C. lying prone with the head of the bed lowered 15-30 degrees
• D. sitting on the edge of the bed with her feet supported and arms and head on a padded overhead table

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

3. Which dietary modification is most suitable for a client with type 2 diabetes who wants to improve glycemic control?

• A. Increase intake of saturated fats
• B. Decrease intake of refined carbohydrates
• C. Completely avoid all fruits
• D. Increase intake of sugary snacks

Correct answer: B

Rationale: Decreasing the intake of refined carbohydrates is the most effective dietary modification for a client with type 2 diabetes who aims to improve their glycemic control. Refined carbohydrates can cause sudden spikes in blood sugar levels, making diabetes management more difficult. Increasing the intake of saturated fats (Choice A) is not advisable as it can negatively impact heart health. Completely avoiding all fruits (Choice C) is unnecessary because most fruits have a low glycemic index and provide essential nutrients. Increasing the intake of sugary snacks (Choice D) will deteriorate glycemic control due to their high sugar content.

4. Which test is used to monitor the degree of blood glucose control over a long period?

• A. Glucose tolerance test
• B. Glycated hemoglobin level
• C. Self-monitoring of blood glucose
• D. 24-hour urinary glucose excretion

Correct answer: B

Rationale: The correct answer is B, glycated hemoglobin level. The glycated hemoglobin (HbA1c) test measures the average blood glucose levels over the past 2-3 months, providing a long-term picture of glucose control. Choice A, the glucose tolerance test, measures how well your body processes glucose but is not specifically for long-term monitoring. Choice C, self-monitoring of blood glucose, involves daily testing by individuals, providing immediate rather than long-term information. Choice D, 24-hour urinary glucose excretion, measures the amount of glucose excreted in the urine over 24 hours and is not typically used for long-term monitoring of blood glucose control.

5. A client with Crohn's disease is receiving parenteral nutrition. Which of the following interventions should the nurse not include in the care of this client?

• A. Remove the parenteral nutrition solution from the refrigerator 2 hours before infusion.
• B. Remove unused parenteral nutrition after 12 hours of use.
• C. Monitor daily laboratory values and report abnormalities as needed.
• D. Monitor the flow rate of the parenteral nutrition carefully and adjust it if necessary.

Correct answer: B

Rationale: In caring for a client receiving parenteral nutrition, it is important to follow proper guidelines to ensure safety and effectiveness. Unused parenteral nutrition should be removed after 24 hours, not 12 hours, to prevent contamination and reduce the risk of infection. Option A is correct as it ensures the solution is at room temperature before infusion. Option C is essential for monitoring the client's response to parenteral nutrition. Option D is important to maintain the correct flow rate and adjust it as needed. Therefore, option B is the incorrect choice among the options provided.

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