Nursing Elites

1. 24 hours after the creation of a colostomy, what should Nurse Violy identify as the normal appearance of the stoma?

• A. Pink, moist, and slightly protruding from the abdomen
• B. Gray, moist, and slightly protruding from the abdomen
• C. Pink, dry, and slightly protruding from the abdomen
• D. Red, moist, and slightly protruding from the abdomen

Correct answer: A

Rationale: Following colostomy surgery, a healthy stoma should appear pink, moist, and slightly protruding from the abdomen, which is why option 'A' is the correct answer. A gray stoma (choice 'B') could indicate poor blood supply or necrosis, which is a serious complication. A dry stoma (choice 'C') is also not normal as it should be moist; a dry stoma may suggest dehydration or other complications. While a stoma can appear red (choice 'D'), this is not typically the normal color; it should usually be pink. Therefore, it's important for healthcare professionals to correctly identify the normal and abnormal appearances of a stoma to ensure proper patient care.

2. A nurse is caring for four clients. The nurse should plan to administer total parenteral nutrition for which of the following clients?

• A. A client who is postoperative following a laminectomy and is receiving IV PCA
• B. A client who has dysphagia and does not recognize his family
• C. A client who has COPD and is going home with oxygen
• D. A client who has colon cancer and will undergo a hemicolectomy

Correct answer: D

Rationale: Total parenteral nutrition (TPN) is essential for clients undergoing significant surgical procedures like a hemicolectomy to ensure they receive adequate nutrition when oral intake is not possible. Choices A, B, and C do not typically require TPN. Choice A is managing postoperative pain with IV PCA, choice B is likely to need alternative feeding methods due to dysphagia, and choice C is going home with oxygen for COPD management, which does not directly relate to the need for TPN.

3. Although a balanced diet is essential for tissue healing and repair, which of the following should the dental hygienist identify as the nutrient of highest priority for a patient with gingivitis or periodontal disease?

• A. Carbohydrates
• B. Vitamin C
• C. Vitamin D
• D. Monosaccharides

Correct answer: B

Rationale: Vitamin C is crucial for collagen production and connective tissue repair, making it a key nutrient for healing gingival tissues in patients with gingivitis or periodontal disease. Carbohydrates are a source of energy and not directly related to tissue repair. Vitamin D is important for bone health but is not the highest priority for gingival tissue healing. Monosaccharides are simple sugars and not as essential for tissue repair as Vitamin C.

4. In kidney disease, which mineral should a patient limit intake of?

• A. Calcium
• B. Magnesium
• C. Phosphorus
• D. Potassium

Correct answer: C

Rationale: In kidney disease, patients are advised to limit the intake of phosphorus. High levels of phosphorus can be problematic as the kidneys may not be able to effectively filter it out, leading to bone health issues. Calcium (Choice A) is important for bone health, but its restriction is not typically necessary in kidney disease. Magnesium (Choice B) and potassium (Choice D) restrictions may be required in certain cases of kidney disease, but phosphorus is the mineral most commonly limited due to its impact on bone health.

5. Because of increasing cases of fluorosis, low levels of fluoride are added to commercial infant formula. Breast milk provides low levels of fluoride.

• 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: D

Rationale: The first statement is false; fluoride is not added to infant formulas due to the risk of fluorosis. The second statement is true; breast milk contains low levels of fluoride.

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