Nursing Elites

1. A client with dysphagia is ready to eat lunch. Which of these foods on the tray would be best to start with when assisting the client?

• A. diced fruit
• B. apple juice with a liquid thickener
• C. Jell-O�
• D. toast

Correct answer: B

Rationale: The correct choice is apple juice with a liquid thickener. A client with dysphagia is at risk for aspiration, so it is crucial to start with liquids and assess the client's ability to swallow before introducing solid foods. Using a liquid thickener with apple juice allows the healthcare provider to evaluate swallowing function. Jell-O�, although it melts into a clear liquid, should be avoided initially as it may not provide a clear assessment of swallowing ability. Diced fruit and toast are solid foods that should be introduced only after the client's swallowing ability with liquids has been assessed.

2. The nurse belongs to a professional nursing organization that provides social, educational, and political venues for nurses. The nurse has been active in this organization for almost two years, during which time she meets and works with nurses from several different nursing agencies and health care institutions to achieve a variety of goals, including obtaining advice regarding a personal career choice. This is an example of:

• A. professional nurturing.
• B. networking.
• C. mentoring.
• D. collegiality.

Correct answer: B

Rationale: Networking involves the process of developing and using contacts throughout one's professional career for information, advice, and support. In this scenario, the nurse is actively engaging with other professionals from various institutions to achieve common goals and seek career advice, which aligns with the concept of networking. Professional nurturing and mentoring focus on providing support and guidance to colleagues, while collegiality refers to the camaraderie and rapport established among individuals through shared experiences, which is not the primary focus of the nurse's interaction in the given situation.

3. Which situation is an example of the use of evidence-based practice in the delivery of client care?

• A. Encouraging a client who has had a stroke to consume thickened liquids and soft foods
• B. Picking up a dislodged radiation implant with long-handled forceps and placing it in a lead container to minimize radiation exposure
• C. Pouring 1 to 2 mL of sterile solution that will be used for wound cleansing into a plastic-lined waste receptacle before pouring the solution into a sterile basin
• D. Blowing on a fingerstick site to dry it after cleaning the site with an alcohol swab

Correct answer: C

Rationale: Evidence-based practice is an approach that integrates client preferences, clinical expertise, and the best research evidence to deliver quality care. Pouring sterile solution into a plastic-lined waste receptacle before using it for wound cleansing reflects evidence-based practice by preventing the entrance of harmful bacteria into the wound. Option A is incorrect because encouraging a stroke client to consume thickened liquids and soft foods is appropriate, not thin liquids and foods that pose a choking risk. Option B is incorrect as picking up a radiation implant with long-handled forceps to minimize radiation exposure is a safety measure, not evidence-based practice. Option D is incorrect because blowing on a fingerstick site after cleaning can recontaminate the site, which goes against best practices in infection control.

4. Which of the following statements by an adult child of a client with late-stage Alzheimer's disease indicates a need for further teaching by the nurse?

• A. "I should provide a regular schedule for toileting."?
• B. "I should talk to my father less because he can't communicate."?
• C. "I should give my father oral care after every meal and bedtime."?
• D. "I should assist my father with eating and drinking."?

Correct answer: B

Rationale: In late-stage Alzheimer's disease, although verbal communication may be challenging or limited, it is essential to maintain communication through talking and non-verbal cues like touching. Limiting communication can lead to feelings of isolation and worsen the emotional well-being of the individual. Choices A, C, and D reflect appropriate care strategies by addressing toileting needs, oral care, and assistance with eating and drinking, which are crucial aspects of caregiving for a client with late-stage Alzheimer's disease.

5. A nursing care plan for a client with sleep problems has been implemented. All of the following should be expected outcomes except:

• A. the client reports no episodes of awakening during the night.
• B. the client falls asleep within 1 hour of going to bed.
• C. the client reports satisfaction with their amount of sleep.
• D. the client rates sleep as an 8 or more on the visual analog scale.

Correct answer: B

Rationale: An expected outcome for a nursing care plan targeting sleep problems is that the client reports no episodes of awakening during the night, the client reports satisfaction with their amount of sleep, and the client rates sleep as an 8 or more on the visual analog scale. Falling asleep within 1 hour of going to bed is not necessarily an expected outcome. While it is generally desirable for individuals to fall asleep within a reasonable time frame, this specific timeframe may vary among individuals, and it is not a strict criterion for successful sleep outcomes. Therefore, the correct answer is that the client falls asleep within 1 hour of going to bed, as this is not a definitive measure of the effectiveness of the nursing care plan for sleep problems.

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