Nursing Elites

1. When counseling a teenager about fast food, a dental hygienist could correctly cite which of the following facts, with one exception. Which is the exception?

• A. Most fast food menus lack a rich source of vitamin A
• B. Consumer demands have driven the establishment of salads and other healthy menu items
• C. Shortages of biotin, folate, pantothenic acid, and copper are reported in fast foods
• D. Studies reveal that protein is lacking in most menu items

Correct answer: D

Rationale: The correct answer is 'D'. Fast food is generally not deficient in protein since it often contains meat, a significant source of protein. On the other hand, fast food is known to lack essential nutrients like Vitamin A and certain minerals, as mentioned in choices 'A' and 'C'. Choice 'B' is also accurate as many fast food establishments have started offering healthier options such as salads due to customer demands. Therefore, all options are true except 'D', which makes it the exception.

2. What should Mrs. Smith do to increase her HDL levels, as advised by the nurse?

• A. Monitor her blood glucose levels
• B. Quit smoking
• C. Control her blood pressure
• D. Take fish oil supplements

Correct answer: B

Rationale: The correct answer is 'Quit smoking.' Smoking has been shown to lower HDL (High-Density Lipoprotein) levels, and quitting can help to improve these levels. HDL is often referred to as 'good cholesterol' because it helps to remove other forms of cholesterol from the bloodstream, reducing the risk of heart disease. While monitoring blood glucose levels, controlling blood pressure, and taking fish oil supplements can contribute to overall health and wellbeing, they do not directly increase HDL levels in the same way that quitting smoking does. Therefore, quitting smoking is the most effective way for Mrs. Smith to increase her HDL levels as advised by the nurse.

3. A client receiving continuous enteral tube feeding reports cramping and abdominal distention. Which of the following actions should the nurse take?

• A. Check for gastric residual.
• B. Apply low intermittent suction.
• C. Increase the rate of the feeding.
• D. Request a higher-fat formula.

Correct answer: A

Rationale: When a client on continuous enteral tube feeding experiences cramping and abdominal distention, the nurse should check for gastric residual. This assessment helps determine if the client is tolerating the feeding well or if there is a potential issue such as feeding intolerance. Applying low intermittent suction, increasing the feeding rate, or requesting a higher-fat formula are not appropriate actions for addressing the reported symptoms and may exacerbate the client's discomfort or lead to further complications.

4. Which client is most likely to need regular injections of vitamin B12?

• A. The client with malabsorption syndrome.
• B. The client following a vegan eating pattern.
• C. The client whose stomach does not produce intrinsic factors.
• D. The client with alcoholism.

Correct answer: C

Rationale: The correct answer is C. The client whose stomach does not produce intrinsic factors is most likely to need regular injections of vitamin B12. Intrinsic factor is essential for the absorption of vitamin B12. Without intrinsic factor, the client cannot absorb vitamin B12 from food, necessitating the need for regular injections. Choices A, B, and D do not directly impact the production of intrinsic factors in the stomach, so they are less likely to result in the need for vitamin B12 injections.

5. In some hip surgeries, an epidural catheter for Fentanyl epidural analgesia is given. What is your nursing priority care in such a case?

• A. Instruct the client to observe strict bed rest
• B. Check for epidural catheter drainage
• C. Administer analgesia through the epidural catheter as prescribed
• D. Assess respiratory rate carefully

Correct answer: D

Rationale: The nursing priority care in a case where an epidural catheter for Fentanyl epidural analgesia is given during hip surgeries is to assess the respiratory rate carefully. Respiratory depression is a potential side effect of Fentanyl, especially when administered epidurally. Monitoring the respiratory rate is crucial to detect any signs of respiratory distress promptly. Instructing the client to observe strict bed rest (Choice A) may be necessary but is not the priority over ensuring respiratory function. Checking for epidural catheter drainage (Choice B) and administering analgesia through the epidural catheter as prescribed (Choice C) are important aspects of care, but ensuring adequate ventilation takes precedence to prevent complications.

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