Nursing Elites

1. Which consumption pattern of fermentable carbohydrate is considered most cariogenic?

• A. A single exposure to a large quantity
• B. A single exposure to a small quantity
• C. Multiple exposures of small quantities
• D. Multiple exposures followed by chewing sugarless gum

Correct answer: C

Rationale: Multiple exposures of small quantities are considered most cariogenic. The total amount of dietary fermentable carbohydrate seems to matter less than the form and frequency in which it is consumed. Having multiple exposures of even small quantities of fermentable carbohydrate throughout the day promotes a highly cariogenic environment in the mouth. Choices A and B, involving single exposures, are less cariogenic as they do not sustain the fermentation process over time. Choice D suggests a beneficial practice by chewing sugarless gum after exposures, which can reduce the risk, making it less cariogenic compared to multiple exposures of small quantities.

2. What special consideration should be taken into account when Mario prepares Richard for postural drainage and percussion?

• A. Monitoring a respiratory rate of 16 to 20 per minute
• B. Assessing the client's ability to tolerate sitting and lying positions
• C. Ensuring the client is free of signs of infection
• D. Knowing the time of the client's last food and fluid intake

Correct answer: A

Rationale: The correct answer is A, 'Monitoring a respiratory rate of 16 to 20 per minute'. When performing postural drainage and percussion, it is crucial to monitor the respiratory rate to ensure the safety and effectiveness of the procedure. Choice B, 'Assessing the client's ability to tolerate sitting and lying positions', while important, is not directly related to the specifics of postural drainage and percussion. Similarly, option C, 'Ensuring the client is free of signs of infection', although important, is not directly linked to the procedure. Option D, 'Knowing the time of the client's last food and fluid intake', might be relevant for other procedures, but it is not the primary consideration for postural drainage and percussion.

3. A client with pre-dialysis end-stage kidney disease is being taught about diet. Which of the following instructions should the nurse include?

• A. Increase intake of dietary phosphorus.
• B. Eliminate foods high in protein from your diet.
• C. Reduce intake of foods high in potassium.
• D. Increase intake of sodium-containing foods.

Correct answer: C

Rationale: In pre-dialysis end-stage kidney disease, reducing intake of foods high in potassium is crucial as impaired kidney function can lead to potassium buildup in the blood, which can be dangerous. High potassium levels can cause irregular heartbeats and even cardiac arrest. Therefore, advising the client to reduce potassium-rich foods is essential to prevent complications. Choices A, B, and D are incorrect. Increasing dietary phosphorus, eliminating foods high in protein, or increasing sodium-containing foods are not appropriate recommendations for a client with pre-dialysis end-stage kidney disease as they can exacerbate the condition.

4. A client with chronic kidney disease is being taught about dietary needs by a nurse. Which of the following foods should the nurse identify as being the lowest in phosphorus?

• A. Medium apple
• B. Bran cereal
• C. Scrambled eggs
• D. Ground turkey

Correct answer: A

Rationale: The correct answer is A, a medium apple. Apples are a suitable option for clients with chronic kidney disease as they are low in phosphorus. Bran cereal (choice B), scrambled eggs (choice C), and ground turkey (choice D) are all higher in phosphorus content compared to apples, making them less ideal choices for individuals with chronic kidney disease.

5. Considering the statement that communication is most effective when barriers are first removed, which of the following is recognized as an inhibiting factor in communication?

• A. Avoidance of universally accepted abbreviations
• B. Usage of incorrect grammar
• C. Poor handwriting
• D. Advanced age of the client

Correct answer: D

Rationale: The correct answer is 'D: Advanced age of the client.' Age can be a significant obstacle in communication due to factors such as hearing loss, cognitive decline, or memory issues, which all can hamper effective communication. Choices A, B, and C, while they may present challenges in communication, are not directly related to age and its influence on communication, making them incorrect. The issues presented by not using universally accepted abbreviations, incorrect grammar, and poor handwriting can be resolved through clarification, education, or the use of alternative communication methods, unlike the difficulties that can arise from advanced age.

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