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. Why are LDLs known as the 'bad' type of cholesterol?

• A. LDL (Low-Density Lipoprotein) is considered 'bad' cholesterol because it deposits cholesterol on the walls of arteries, leading to plaque formation and narrowing of the arteries (atherosclerosis).
• B. Both the statement and the reason are correct but are not related
• C. The statement is correct, but the reason is not correct
• D. The statement is not correct, but the reason is correct

Correct answer: A

Rationale: LDL (Low-Density Lipoprotein) is known as the 'bad' type of cholesterol because it deposits cholesterol on the walls of arteries, leading to plaque formation and narrowing of the arteries (atherosclerosis). This narrowing can restrict blood flow and increase the risk of serious cardiovascular conditions. The statement and the reason are directly related because the adherence of LDL to arterial walls and the subsequent narrowing of the lumen are the primary reasons why it is considered detrimental to heart health. Choice B is incorrect because the statement and reason are related. Choice C is incorrect because both the statement and the reason are correct. Choice D is incorrect because the statement correctly identifies LDL as the 'bad' type of cholesterol due to its actions in the arteries.

3. A dietitian tells you that you are not consuming enough calories. Which of the following nutrients could you add to your diet to increase your energy intake?

• A. fiber
• B. water
• C. protein
• D. vitamins

Correct answer: C

Rationale: Corrected Rationale: Protein provides 4 kcal per gram, making it a good source of energy to increase caloric intake. While fiber and water are important for other aspects of health, they do not provide energy like protein does. Vitamins are essential for various bodily functions but do not contribute directly to caloric intake.

4. The parent of a child newly diagnosed with lactose intolerance is being taught by the nurse. Which food items identified by the parent indicate an understanding of foods to avoid?

• A. Popcorn, seeds, and any foods containing nuts.
• B. Milk, cheese, ice cream, and puddings.
• C. Wheat, rye, barley, and commercially baked goods.
• D. Eggs, ham, bacon, and canned meats.

Correct answer: B

Rationale: The correct answer is B. Milk, cheese, ice cream, and puddings contain lactose, which individuals with lactose intolerance should avoid. Choices A, C, and D do not contain lactose and are not typically problematic for individuals with lactose intolerance.

5. _____ neutralizes stomach acid in the small intestine:

• A. saliva
• B. gastric mucus
• C. bicarbonate ions
• D. enzymes

Correct answer: C

Rationale: The correct answer is C: bicarbonate ions. Bicarbonate ions, secreted by the pancreas, neutralize the acidic chyme entering the small intestine from the stomach, creating a more suitable environment for digestive enzymes. Saliva (choice A) helps in the initial breakdown of food in the mouth, not in neutralizing stomach acid. Gastric mucus (choice B) protects the stomach lining from the acidic environment but does not neutralize the acid in the small intestine. Enzymes (choice D) facilitate chemical reactions in digestion but do not neutralize stomach acid.

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