Nursing Elites

1. A client has acute dysphagia. Which of the following nursing interventions should be included in the plan of care?

• A. Providing a straw for consumption of liquids
• B. Encouraging larger bites
• C. Placing the client in semi-Fowler's position during meals
• D. Instructing the client to tilt head forward when swallowing

Correct answer: C

Rationale: Placing the client in semi-Fowler's position during meals is the correct intervention for a client with acute dysphagia. This position helps prevent aspiration by facilitating swallowing. Providing a straw for consumption of liquids (Choice A) can increase the risk of aspiration and is not recommended for clients with dysphagia. Encouraging larger bites (Choice B) can also increase the risk of choking and aspiration. Instructing the client to tilt the head forward when swallowing (Choice D) is not the recommended technique for managing dysphagia as it does not address the underlying issue effectively.

2. During the acute phase of a burn, the priority nursing intervention in caring for this client is:

• A. Prevention of infection
• B. Pain management
• C. Prevention of bleeding
• D. Fluid resuscitation

Correct answer: D

Rationale: During the acute phase of a burn, fluid resuscitation is the priority nursing intervention. This phase is characterized by fluid loss and the risk of hypovolemic shock. Administering fluids is crucial to maintain perfusion and prevent complications such as organ failure. While prevention of infection, pain management, and prevention of bleeding are important aspects of burn care, fluid resuscitation takes precedence in the acute phase to stabilize the client's condition and prevent further damage.

3. How is the equalization of solute concentration of intracellular fluids (ICFs) and extracellular fluids (ECFs accomplished?

• A. Semipermeable membranes.
• B. Hydration.
• C. Osmotic pressure.
• D. Perspiration.

Correct answer: C

Rationale: The correct answer is C, osmotic pressure. Osmotic pressure within the body equalizes the solute concentration of ICFs and ECFs by shifting small amounts of water in the direction of higher concentration solute. Semipermeable membranes separate one fluid compartment from another and do not directly equalize solute concentrations. Hydration and perspiration are important elements of fluid balance but do not directly achieve the equalization of solute concentrations between ICFs and ECFs, which is primarily regulated by osmotic pressure.

4. Much of the research investigating probiotics and intestinal illness has focused on the prevention and treatment of _____.

• A. irritable bowel syndrome
• B. Crohn's disease
• C. diverticulitis
• D. infectious diarrhea

Correct answer: D

Rationale: The correct answer is 'D: infectious diarrhea.' Research has extensively explored the use of probiotics in the prevention and treatment of infectious diarrhea. Probiotics can aid in restoring the balance of gut flora, thereby reducing symptoms. Choices A, B, and C are incorrect because while probiotics may have some benefits for these conditions, the primary focus of research in relation to probiotics and intestinal illness has been on infectious diarrhea.

5. A client who has dumping syndrome following a hemi-colectomy should avoid which of the following foods when receiving nutritional teaching from a nurse?

• A. Rice
• B. Poached eggs
• C. Fresh apples
• D. White bread

Correct answer: C

Rationale: Fresh apples should be avoided by a client with dumping syndrome following a hemi-colectomy because they are high in fiber and can exacerbate gastrointestinal symptoms such as diarrhea and bloating. Rice and poached eggs are good options as they are easily digestible and less likely to trigger dumping syndrome symptoms. White bread is also preferable over whole grain bread due to its lower fiber content, making it a better choice for individuals with dumping syndrome.

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