Nursing Elites

1. A client who has chronic lymphocytic leukemia is starting chemotherapy treatments and asks if she needs to make any dietary changes. Which of the following statements should the nurse make?

• A. "You should avoid drinking liquids an hour before the treatments."?
• B. "Eating low-calorie foods helps prevent nausea."?
• C. "Foods that are higher in fat are usually more appealing."?
• D. "Raw fruits and vegetables will be easier for your body to digest."?

Correct answer: D

Rationale: During chemotherapy treatments for chronic lymphocytic leukemia, raw fruits and vegetables are recommended as they are easier for the body to digest. This choice provides essential nutrients and is gentle on the digestive system. Option A is incorrect because staying hydrated is crucial during chemotherapy. Option B is incorrect as low-calorie foods may not provide sufficient energy during treatment. Option C is incorrect because high-fat foods are not typically recommended due to potential digestive issues.

2. Which outcome has been shown to be most closely associated with breastfeeding infants of mothers who smoke?

• A. poor temperature regulation
• B. vision impairment
• C. vomiting
• D. elevated blood pressure

Correct answer: C

Rationale: The correct answer is C: vomiting. Infants breastfed by mothers who smoke are more likely to experience vomiting and gastrointestinal issues due to the transfer of nicotine and other harmful substances through breast milk. Choices A, B, and D are incorrect. Poor temperature regulation, vision impairment, and elevated blood pressure are not the primary outcomes closely associated with breastfeeding infants of mothers who smoke.

3. Electrolytes create _____, which is caused by water following electrolytes within or between cells.

• A. energy
• B. active transport
• C. passive diffusion
• D. osmotic pressure

Correct answer: D

Rationale: Osmotic pressure is the force that drives water movement across cell membranes due to the presence of electrolytes, helping to balance fluid levels in the body. Choice A, 'energy,' is incorrect as electrolytes do not directly create energy. Choice B, 'active transport,' refers to the movement of molecules across a cell membrane requiring energy, not the movement of water. Choice C, 'passive diffusion,' is the process by which substances move from an area of higher concentration to lower concentration, not related to the movement of water following electrolytes.

4. When performing endotracheal suctioning, the nurse applies suctioning while withdrawing and gently rotating the catheter 360 degrees for which of the following time periods?

• A. 10-15 seconds
• B. 30-35 seconds
• C. 20-25 seconds
• D. 0-5 seconds

Correct answer: D

Rationale: During endotracheal suctioning, the nurse should apply suctioning while withdrawing and gently rotating the catheter 360 degrees for a short period of 0-5 seconds. This brief duration helps minimize the risk of hypoxia and trauma to the airway. Choices A, B, and C suggest longer time periods for suctioning, which can increase the risk of complications such as hypoxia, mucosal damage, and the removal of excess amounts of airway secretions.

5. The nurse notes that the fall might also cause a possible head injury. The patient will be observed for signs of increased intracranial pressure which include:

• A. Narrowing of the pulse pressure
• B. Vomiting
• C. Periorbital edema
• D. A positive Kernig's sign

Correct answer: C

Rationale: Periorbital edema is a sign of increased intracranial pressure. It is caused by fluid accumulation around the eyes due to compromised drainage. Narrowing of the pulse pressure is more indicative of shock than increased intracranial pressure. While vomiting can be a sign of increased intracranial pressure, it is not as specific as periorbital edema. A positive Kernig's sign is associated with meningitis, not increased intracranial pressure.

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