Nursing Elites

1. A nurse is caring for a client following an appendectomy. The nurse verifies the postoperative prescription which reads, 'Discontinue NPO status; advance diet as tolerated.' Which of the following are appropriate for the nurse to offer the client? (SATA)

• A. Wheat toast
• B. Applesauce
• C. Applesauce, Chicken broth
• D. Chicken broth

Correct answer: C

Rationale: The correct answer is C: Applesauce and chicken broth. After an appendectomy, patients are typically started on a clear liquid diet before advancing to more solid foods. Applesauce and chicken broth are part of a low-residue diet that is easily digestible and gentle on the digestive system, making them suitable choices for a client following surgery. Wheat toast may be too heavy and fibrous initially, while other solid foods should be introduced gradually to prevent gastrointestinal upset.

2. What condition has been shown to be associated with esophageal dysphagia?

• A. myasthenia gravis
• B. achalasia
• C. Alzheimer's disease
• D. cerebral palsy

Correct answer: B

Rationale: Achalasia is the correct answer. It is a condition characterized by the esophagus having difficulty moving food toward the stomach, resulting in dysphagia (difficulty swallowing). Myasthenia gravis (Choice A) is a neuromuscular disorder that affects skeletal muscles, not the esophagus. Alzheimer's disease (Choice C) primarily affects cognitive function, not the esophagus. Cerebral palsy (Choice D) is a neurological disorder affecting body movement and muscle coordination, unrelated to esophageal dysphagia.

3. The purpose of chest percussion and vibration is to loosen secretions in the lungs. The difference between the procedures is:

• A. Percussion uses only one hand, while vibration uses both hands
• B. Percussion delivers cushioned blows to the chest with cupped palms, while vibration gently shakes secretions loose
• C. In both percussion and vibration, the hands are not on top of each other, and hand action is not in tune with the client's breath
• D. Percussion slaps the chest to loosen secretions, while vibration shakes the secretions along with the inhalation

Correct answer: D

Rationale: Chest percussion involves the use of rhythmic tapping to dislodge mucus from the lungs, facilitating its movement toward the larger airways where it can be expelled. This technique is particularly important in conditions where mucus retention is a significant risk factor for infection. The key difference between chest percussion and vibration is that percussion involves slapping the chest to loosen secretions, while vibration involves shaking the secretions along with the inhalation, aiding in moving the loosened secretions upwards for easier removal. Choices A, B, and C do not accurately describe the main difference between chest percussion and vibration, making them incorrect.

4. What food is most likely a source of trans fats in the diet?

• A. red meat
• B. peanut oil
• C. corn chips
• D. salmon

Correct answer: C

Rationale: The correct answer is C: corn chips. Corn chips, especially those processed and fried, are a common source of trans fats, which are associated with an increased risk of heart disease. Red meat (choice A) and salmon (choice D) do not typically contain trans fats unless they are processed or cooked in trans fat-containing oils. Peanut oil (choice B) can be a healthier option compared to trans fat-containing oils.

5. Which vitamin acts most like a hormone?

• A. Vitamin A
• B. Vitamin B
• C. Vitamin D
• D. Vitamin C

Correct answer: C

Rationale: The correct answer is Vitamin D. Although vitamin D, also known as calciferol, has been called a vitamin, it is more appropriately classified as a hormone. Like hormones, vitamin D acts to control the function of other cell types. For example, it helps the body absorb and regulate skeletal calcium and phosphorus levels. Choice A (Vitamin A) plays a crucial role in vision and immune function. Choice B (Vitamin B) is a complex of different vitamins that play various roles in the body. Choice D (Vitamin C) is important for collagen production and acts as an antioxidant.

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