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. Which nutrient is most important for maintaining fluid balance in the body?

• A. Protein
• B. Sodium
• C. Calcium
• D. Vitamin C

Correct answer: B

Rationale: Sodium plays a key role in maintaining fluid balance and regulating blood pressure.

3. What is the function of villi and microvilli in the GI tract?

• A. produce bile
• B. kill bacteria
• C. produce vitamin K
• D. increase the surface area for absorption

Correct answer: D

Rationale: Villi and microvilli in the GI tract serve to increase the surface area of the small intestine, aiding in the absorption of nutrients into the bloodstream. Choices A, B, and C are incorrect as villi and microvilli are primarily involved in enhancing absorption, not in producing bile, killing bacteria, or producing vitamin K.

4. What stimulates bile secretion from the liver to the small intestine?

• A. Pepsin
• B. Salivary Amylase
• C. CCK
• D. Secretin

Correct answer: C

Rationale: Cholecystokinin (CCK) is the hormone that stimulates the release of bile from the gallbladder into the small intestine, aiding in fat digestion. Pepsin is an enzyme in the stomach that breaks down proteins into smaller peptides, not involved in bile secretion. Salivary Amylase is an enzyme in saliva that initiates starch digestion in the mouth, not related to bile secretion. Secretin is a hormone that regulates the release of gastric juice in the stomach and triggers the pancreas to neutralize stomach acid in the small intestine, but it does not stimulate bile secretion.

5. A client with stomatitis is receiving teaching from a nurse. Which of the following client statements indicates a need for further teaching?

• A. "I will drink liquids through a straw."?
• B. "I will season foods with dried spices before cooking."?
• C. "I will rinse my mouth with baking soda and water frequently."?
• D. "I will eat frozen bananas as a snack."?

Correct answer: C

Rationale: The correct answer is, "I will rinse my mouth with baking soda and water frequently."? Stomatitis is an inflammation of the mucous lining in the mouth, and rinsing with baking soda and water can be too abrasive and further irritate the condition. Choices A, B, and D are appropriate self-care measures for a client with stomatitis and do not indicate a need for further teaching.

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