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. A client is being educated by a nurse on snacks suitable for a low-fat, low-sodium, and low-cholesterol diet. Which of the following food choices by the client indicates the need for further teaching?

• A. A slice of cheese
• B. A jam sandwich
• C. A cup of plain popcorn
• D. A small container of applesauce

Correct answer: A

Rationale: The correct answer is A: A slice of cheese. Cheese is high in fat, sodium, and cholesterol, making it unsuitable for a low-fat, low-sodium, and low-cholesterol diet. Choices B, C, and D are more appropriate for such a diet. B: A jam sandwich can be low in fat, sodium, and cholesterol if made with whole grain bread and a low-sugar jam. C: A cup of plain popcorn is a good choice as it is low in fat and can be made without added salt. D: A small container of applesauce is also a suitable option for a low-fat, low-sodium, and low-cholesterol diet.

3. A nurse at a health fair is assessing the weight status of four clients. Which of the following clients is classified as overweight?

• A. A female client who has a body mass index of 24
• B. A male client who has a body mass index of 29
• C. A female client who has a waist circumference of 101.6 cm (40 in)
• D. A male client who has a waist circumference of 96.52 cm (38 in)

Correct answer: B

Rationale: A body mass index (BMI) of 25 or higher is classified as overweight. Choice B, a male client with a BMI of 29, falls into the overweight category. Choice A, a female client with a BMI of 24, is within the normal range. Choices C and D provide information on waist circumference, which is not sufficient to determine if a client is overweight or not, as waist circumference alone does not provide the overall picture of weight status compared to BMI.

4. Which enzyme is most essential for hydrolyzing large protein molecules?

• A. Gastric lipase
• B. Pepsin
• C. Mucus
• D. Intrinsic factor

Correct answer: B

Rationale: Pepsin, choice B, is the correct answer as it is a proteolytic enzyme that is essential for the breakdown of large protein molecules in the stomach. Gastric lipase, choice A, is incorrect because it primarily targets fats, not proteins, hence it is not involved in protein hydrolysis. Mucus, choice C, is incorrect as it serves to protect the stomach lining from acidic gastric juices and does not play a direct role in protein digestion. Intrinsic factor, choice D, is incorrect as it is vital for the absorption of Vitamin B12 in the small intestine and doesn't participate in the process of hydrolyzing proteins.

5. Which of the following is a tricyclic antidepressant drug?

• A. Venlafaxine (Effexor)
• B. Fluoxetine (Prozac)
• C. Sertraline (Zoloft)
• D. Imipramine (Tofranil)

Correct answer: D

Rationale: Imipramine (Tofranil) is a tricyclic antidepressant drug. This class of medications is used to treat depression, and they work by increasing the levels of certain chemicals in the brain that help lift mood. On the other hand, Venlafaxine (Effexor) is a serotonin and norepinephrine reuptake inhibitor (SNRI), Fluoxetine (Prozac) is a selective serotonin reuptake inhibitor (SSRI), and Sertraline (Zoloft) is also an SSRI. Therefore, they are not classified as tricyclic antidepressants.

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