Nursing Elites

1. A client is diagnosed with ariboflavinosis. Which of the following foods should the nurse serve this client?

• A. Citrus fruits
• B. Milk
• C. Fish
• D. Potatoes

Correct answer: B

Rationale: Ariboflavinosis is a vitamin B-2 deficiency. Symptoms may include cracks around the mouth, inflammation of the tongue, or light sensitivity. Foods rich in vitamin B-2, like milk, liver, green vegetables, or whole grains, are recommended. Citrus fruits (choice A) are good sources of vitamin C, not B-2. Fish (choice C) is a source of protein and omega-3 fatty acids but not a significant source of vitamin B-2. Potatoes (choice D) are a source of carbohydrates but do not provide high levels of vitamin B-2.

2. The nurse is reviewing percussion techniques with a new graduate nurse. Which action performed by the graduate nurse while percussing requires the nurse to intervene?

• A. Percussing twice over each area
• B. Striking with the fingertip, not the finger pad
• C. Using the wrist to make the strikes, not the arm
• D. Quickly lifting the striking finger after each stroke

Correct answer: A

Rationale: The correct answer is to percuss twice over each area, not once. This technique helps ensure a more accurate assessment. Striking with the fingertip instead of the finger pad is correct because the tip of the finger produces clearer sounds. Using the wrist to make the strikes instead of the arm is appropriate as it allows for more controlled and precise percussion. Quickly lifting the striking finger after each stroke is also correct to prevent damping off vibrations. Therefore, percussing once over each area (Choice A) is incorrect as it does not follow the standard percussion technique.

3. A patient's body temperature has varied over the last 24 hours from 97.6 degrees F in the morning to 99 degrees F in the evening. The patient is worried that this change in temperature may indicate the beginning of a fever. Which of the following BEST explains this phenomenon?

• A. The patient definitely has a fever in the evening and should be seen by a doctor.
• B. The patient is experiencing changes related to a diurnal rhythm.
• C. The patient is more than likely taking their temperature incorrectly.
• D. The patient is experiencing changes related to fluctuating daily hormones.

Correct answer: B

Rationale: The patient is experiencing changes related to a diurnal rhythm. Diurnal rhythm is the phenomenon of body temperature fluctuating depending on the time of day. Temperatures taken in the morning are typically lower than those taken throughout the rest of the day. Choice A is incorrect because a single elevated temperature reading in the evening does not definitively indicate a fever. Choice C is incorrect as there is no indication of incorrect temperature measurement. Choice D is incorrect as the temperature changes are not related to monthly hormones but rather to the body's natural daily rhythm.

4. Which statement best describes evidence-based practice?

• A. Reading and analyzing research reports to determine their implementation in nursing practice
• B. Collecting data to evaluate the efficiency of nursing practice in delivering quality care
• C. Monitoring unit practices to ensure adherence to Joint Commission standards
• D. Using the most effective, current, and applicable information to guide nursing care for the best outcomes

Correct answer: D

Rationale: Evidence-based practice involves utilizing the most effective, current, and relevant information to inform nursing care decisions for optimal client outcomes. While research reports and data collection are important components of evidence-based practice, the essence lies in integrating all available information to determine the best course of action. Monitoring compliance with standards, as described in choices A and C, is essential for quality assurance but does not capture the comprehensive nature of evidence-based practice.

5. What does the medical term 'basophilia' refer to?

• A. An attachment of the epithelial cells of the skin to a basement membrane
• B. An overabundance of a particular white blood cell in the peripheral blood
• C. An underrepresentation of basophils on a blood smear
• D. None of the above

Correct answer: B

Rationale: The correct answer is 'An overabundance of a particular white blood cell in the peripheral blood.' Basophilia specifically indicates an increased number of basophils in the peripheral blood. It can be observed in conditions like leukemia and certain allergic reactions. Choice A is incorrect as it describes something unrelated to basophilia. Choice C is incorrect as it suggests a decrease in basophils, which is opposite to the actual meaning of basophilia. Choice D is also incorrect as basophilia does have a defined medical significance.

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