Nursing Elites

1. A charge nurse is explaining the various stages of the lifespan to a group of newly licensed nurses. Which of the following examples should the charge nurse include as a developmental task for a young adult?

• A. Becoming actively involved in providing guidance to the next generation.
• B. Adjusting to major changes in roles and relationships due to losses.
• C. Devoting time to establishing an occupation.
• D. Finding oneself 'sandwiched' between and being responsible for two generations.

Correct answer: C

Rationale: The correct answer is C: Devoting time to establishing an occupation. Young adults typically focus on building their careers and personal identities, making establishing an occupation a crucial developmental task for this age group. Choices A, B, and D do not align with the typical developmental tasks of young adults. Choice A relates more to middle adulthood where individuals take on mentoring roles, choice B is more characteristic of the tasks associated with adjusting to late adulthood, and choice D is more relevant to middle adulthood when individuals may find themselves caring for both their own children and aging parents.

2. A client with a prescription for a clear liquid diet is receiving teaching about food choices from a nurse. Which of the following selections by the client indicates an understanding of the teaching?

• A. Gelatin
• B. Whole milk
• C. Cream soups
• D. Orange juice

Correct answer: A

Rationale: The correct answer is A: Gelatin. Gelatin is suitable for a clear liquid diet because it is transparent and free of solid particles. Clear liquid diets are designed to be easily digested and leave minimal residue in the gastrointestinal tract. Choices B, C, and D are not appropriate for a clear liquid diet. Whole milk, cream soups, and orange juice contain solid particles or pulp, which are not allowed on a clear liquid diet. Whole milk and cream soups are not clear liquids as they contain milk solids and vegetable particles respectively. Orange juice contains pulp, which is not part of a clear liquid diet. It is important for clients to follow dietary restrictions to achieve the intended therapeutic outcomes.

3. A nurse in a provider's office is assessing the deep tendon reflexes of a client. Which of the following techniques should the nurse identify as indicating the correct method for eliciting the client's patellar reflex?

• A. Tap just below the knee
• B. Tap on the upper thigh
• C. Tap on the ankle
• D. Tap on the lower leg

Correct answer: A

Rationale: The correct technique for eliciting the client's patellar reflex is to tap just below the knee. This action stimulates the stretch receptors in the patellar tendon, leading to a reflex contraction of the quadriceps muscle and extension of the lower leg. Tapping on the upper thigh (Choice B) would not elicit the patellar reflex as it targets a different area. Similarly, tapping on the ankle (Choice C) or tapping on the lower leg (Choice D) would not produce the desired response associated with the patellar reflex, making them incorrect choices.

4. A client with a history of alcoholism is admitted with confusion and ataxia. The LPN/LVN recognizes that these symptoms may be related to a deficiency in which vitamin?

• A. Vitamin A
• B. Vitamin C
• C. Vitamin D
• D. Vitamin B1 (Thiamine)

Correct answer: D

Rationale: The correct answer is Vitamin B1 (Thiamine). Vitamin B1 deficiency, also known as Thiamine deficiency, is common in clients with a history of alcoholism. Thiamine is essential for proper brain function, and its deficiency can lead to neurological symptoms such as confusion and ataxia. Vitamin A, C, and D deficiencies do not typically present with confusion and ataxia in the context of alcoholism. Vitamin A deficiency mainly affects vision, Vitamin C deficiency leads to scurvy with symptoms like bleeding gums, and Vitamin D deficiency is associated with bone disorders. Therefore, they are not the correct choices in this scenario.

5. A healthcare provider is receiving a prescription for a client who is experiencing dysphagia following a stroke. Which of the following prescriptions should the healthcare provider clarify?

• A. Dietitian consult
• B. Speech therapy referral
• C. Oral suction at the bedside
• D. Clear liquids

Correct answer: D

Rationale: The correct answer is D: 'Clear liquids.' Clients with dysphagia following a stroke are at high risk of aspiration, and clear liquids have a higher risk of aspiration compared to thickened liquids. Therefore, the healthcare provider should clarify the prescription for clear liquids and consider recommending thickened liquids instead to reduce the risk of aspiration. Choice A, 'Dietitian consult,' is essential to ensure the client receives appropriate nutrition tailored to their condition. Choice B, 'Speech therapy referral,' is crucial for dysphagia management and rehabilitation. Choice C, 'Oral suction at the bedside,' is a standard intervention to maintain airway patency and is not contraindicated in clients with dysphagia.

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