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. A nurse is planning care for a client who reports increasing difficulty swallowing food. Which of the following interventions should the nurse plan to take?

• A. Turn on the client’s television during meals.
• B. Place the client into a semi-reclining position for meals.
• C. Encourage the client to rest prior to mealtimes.
• D. Encourage the client to use a straw when drinking liquids.

Correct answer: C

Rationale: The correct answer is to encourage the client to rest prior to mealtimes. This intervention can help reduce fatigue and improve the ability to swallow. Turning on the client’s television during meals (choice A) may distract the client but does not directly address the swallowing issue. Placing the client into a semi-reclining position for meals (choice B) can help with swallowing difficulties, but resting before meals is more beneficial. Encouraging the client to use a straw when drinking liquids (choice D) is not the priority intervention for swallowing difficulties in this scenario.

3. A nurse is caring for a client following a CVA and observes the client experiencing severe dysphagia. The nurse notifies the provider. Which of the following nutritional therapies will likely be prescribed?

• A. NPO until dysphagia subsides
• B. Supplements via nasogastric tube
• C. Initiation of total parenteral nutrition
• D. Soft residue diet

Correct answer: B

Rationale: In the scenario of severe dysphagia following a CVA, the client may have difficulty swallowing and require alternative nutritional support. Providing supplements via a nasogastric tube allows for the delivery of essential nutrients directly into the stomach, bypassing the swallowing difficulties. NPO (nothing by mouth) until dysphagia subsides may be too restrictive for the client's nutritional needs. Initiation of total parenteral nutrition is usually reserved for cases where enteral feeding is not possible or contraindicated. A soft residue diet may not be suitable for a client experiencing severe dysphagia.

4. Each is a portion of the alimentary canal, except one. Which is the exception?

• A. Oral cavity
• B. Pharynx
• C. Larynx
• D. Esophagus

Correct answer: C

Rationale: The correct answer is C, Larynx. The larynx is part of the respiratory system, responsible for voice production and breathing. The alimentary canal is involved in the digestive process and includes structures like the oral cavity (mouth), pharynx, and esophagus. Choices A, B, and D are parts of the alimentary canal, where digestion occurs, making them incorrect answers.

5. The purpose of the health history is to identify health-related considerations and medications that may cause nutritional risk. Many medications, such as prednisone, have drug-nutrient interactions that can influence nutrient needs.

• A. Both statements are true
• B. Both statements are false
• C. The first statement is true; the second is false
• D. The first statement is false; the second is true

Correct answer: A

Rationale: Both statements are true. The health history aims to uncover health-related factors that could pose nutritional risks, including medications like prednisone that may have interactions affecting nutrient requirements. Choice B is incorrect as both statements are accurate, emphasizing the significance of health history in assessing nutritional concerns.

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