Nursing Elites

1. A nurse is providing teaching to a client with gastroesophageal reflux. Which of the following statements by the client indicates a need for further teaching?

• A. I should elevate the head of my bed while sleeping.
• B. I drink no more than 4 cups of coffee a day.
• C. I take my time when I am eating.
• D. I avoid foods and drinks made with chocolate.

Correct answer: B

Rationale: The correct answer is B: 'I drink no more than 4 cups of coffee a day.' Excessive coffee consumption can aggravate gastroesophageal reflux due to its acidic nature. Choices A, C, and D are all appropriate self-care measures for managing gastroesophageal reflux. Elevating the head of the bed while sleeping helps prevent acid reflux, eating slowly can reduce reflux episodes, and avoiding trigger foods like chocolate can help alleviate symptoms.

2. Which chemical structure is represented by glycerol combined with two fatty acids?

• A. Compound lipids
• B. Monoglycerides
• C. Diglycerides
• D. Structural lipids

Correct answer: C

Rationale: The correct answer is C: Diglycerides. A diglyceride is a glycerol molecule combined with two fatty acids. This is a common form of fat during digestion and absorption. Choice A, Compound lipids, is incorrect because these lipids are composed of simple lipids plus additional compounds, which is not the case with a glycerol molecule combined with two fatty acids. Choice B, Monoglycerides, is incorrect because these are glycerol molecules combined with only one fatty acid, not two. Lastly, choice D, Structural lipids, is incorrect because these are major components of cell membranes and do not directly relate to the combination of glycerol and two fatty acids.

3. Surgery schedules are communicated to the OR usually a day prior to the procedure by the nurse of the floor or ward where the patient is confined. For orthopedic cases, what department is usually informed to be present in the OR?

• A. Rehabilitation department
• B. Laboratory department
• C. Maintenance department
• D. Radiology department

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.

4. The nurse is working with a patient who recently had a stroke. The patient frequently chokes and coughs when eating and is having difficulty feeding herself. What is the best way to ensure adequate nutrition?

• A. to have an aide feed her at each meal
• B. to ask a family member to assist during meals
• C. to provide tube feedings for the patient
• D. to initiate TPN for the patient

Correct answer: C

Rationale: The best way to ensure adequate nutrition for a stroke patient who frequently chokes and coughs when eating and has difficulty feeding herself is to provide tube feedings. Tube feedings are a safe and effective method to deliver nutrition directly to the stomach or intestines, bypassing the swallowing mechanism, reducing the risk of aspiration. Having an aide feed her each meal (choice A) may not address the underlying issue of swallowing difficulty and aspiration risk. Asking a family member to be present at each meal (choice B) does not provide a definitive solution to the patient's nutritional needs. Placing the patient on total parenteral nutrition (TPN) (choice D) is a more invasive and typically reserved for patients who cannot tolerate enteral feedings or have non-functional gastrointestinal tracts.

5. What is the movement of water from an area of lower solute concentration to one of higher solute concentration called?

• A. Hypodipsia
• B. Hypernatremia
• C. Hypokalemia
• D. Osmosis

Correct answer: D

Rationale: The correct answer is D, Osmosis. Osmosis is the process where water moves from an area of low solute concentration to an area of high solute concentration. This movement equalizes the solute concentration in intracellular and extracellular fluids. Choices A, B, and C are incorrect because they do not describe the movement of water based on solute concentration levels.

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