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. While evaluating the meal choices of a client with major depressive disorder and a prescription of Phenelzine, which of the following selections should the nurse identify as appropriate?

• A. Cheddar cheese
• B. Smoked salmon
• C. Strawberry yogurt
• D. Pepperoni pizza

Correct answer: C

Rationale: The correct answer is C, 'Strawberry yogurt.' This choice is appropriate because it does not contain high levels of tyramine, which can lead to a dangerous interaction with Phenelzine, a monoamine oxidase inhibitor. Tyramine-rich foods, like aged cheeses (such as cheddar cheese) and cured meats (like smoked salmon and pepperoni), should be avoided by individuals taking Phenelzine to prevent hypertensive crisis. Strawberry yogurt is a safer option for the client in this scenario.

3. Which nutrients might people who follow a vegan diet be deficient in?

• A. Vitamin B12
• B. Vitamin C
• C. Vitamins A and D
• D. Calcium

Correct answer: C

Rationale: People who adhere to a vegan diet might indeed be deficient in vitamins A and D, which are primarily found in animal-derived foods. While vitamin B12 and calcium can also be lacking in a vegan diet, these were not choices given that would correctly answer the question. Vitamin C, on the other hand, is widely available in numerous plant-based foods, making it less likely for vegans to be deficient in it. Therefore, the correct answer is 'Vitamins A and D'. It's important to note that deficiencies can be avoided through careful meal planning or supplementation.

4. Which breakfast items indicate an understanding of foods high in antioxidants A and C?

• A. Fried eggs, sausage, and whole wheat toast
• B. Oatmeal with blueberries and coffee
• C. Cereal with strawberries and low-fat milk
• D. Hard-boiled eggs, cantaloupe, and orange juice

Correct answer: D

Rationale: The correct answer is D: Hard-boiled eggs, cantaloupe, and orange juice. Cantaloupe and orange juice are rich in vitamins A and C, which are known for their antioxidant properties. Choice A is incorrect because fried eggs, sausage, and whole wheat toast do not contain high levels of antioxidants A and C. Choice B is incorrect because, while blueberries are high in antioxidants, coffee does not provide significant amounts of vitamins A and C. Choice C is incorrect because, although strawberries are a good source of vitamin C, low-fat milk does not contribute significantly to vitamins A and C.

5. A nurse is providing teaching to a group of parents of newborns who are planning to formula feed. Which of the following statements by a parent indicates a need for further teaching?

• A. "I will give formula to my baby at room temperature."
• B. "I will ensure my baby's feeds last 10 to 15 minutes."
• C. "I will burp my baby halfway through each feeding."
• D. "I will watch for signs my baby is full and stop the feeding."

Correct answer: B

Rationale: The correct answer is, "I will ensure my baby's feeds last 10 to 15 minutes." This statement indicates a need for further teaching because it suggests a strict time limit for feedings, which may not be appropriate for a newborn. Newborns should be allowed to feed as long as they want, typically around 20-30 minutes per breast if breastfeeding, or on-demand with formula. Choices A, C, and D demonstrate proper feeding practices such as feeding at room temperature, burping halfway through each feeding, and watching for signs of fullness to stop the feeding, which are all appropriate responses by a parent of a formula-fed newborn.

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