Nursing Elites

1. 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.

2. A dental hygienist finds several new carious lesions in a patient with chronic obstructive respiratory disease (COPD). While conducting the medical and dental histories, the dental hygienist is most likely to find an increased use of which of the following?

• A. Protein
• B. Cough drops
• C. Fluoride
• D. Xylitol

Correct answer: B

Rationale: The correct answer is B: Cough drops. Patients with COPD often use cough drops to manage their symptoms, which can lead to an increase in carious lesions due to their sugar content. Choices A, C, and D are incorrect as protein, fluoride, and xylitol are not typically associated with an increased risk of carious lesions in patients with COPD.

3. The purpose of chest percussion and vibration is to loosen secretions in the lungs. The difference between the procedures is:

• A. Percussion uses only one hand, while vibration uses both hands
• B. Percussion delivers cushioned blows to the chest with cupped palms, while vibration gently shakes secretions loose
• C. In both percussion and vibration, the hands are not on top of each other, and hand action is not in tune with the client's breath
• D. Percussion slaps the chest to loosen secretions, while vibration shakes the secretions along with the inhalation

Correct answer: D

Rationale: Chest percussion involves the use of rhythmic tapping to dislodge mucus from the lungs, facilitating its movement toward the larger airways where it can be expelled. This technique is particularly important in conditions where mucus retention is a significant risk factor for infection. The key difference between chest percussion and vibration is that percussion involves slapping the chest to loosen secretions, while vibration involves shaking the secretions along with the inhalation, aiding in moving the loosened secretions upwards for easier removal. Choices A, B, and C do not accurately describe the main difference between chest percussion and vibration, making them incorrect.

4. 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.

5. Skin care around the stoma is critical. Which of the following is not indicated as a skin care barriers?

• A. Apply liberal amount of mineral oil to the area
• B. Use karaya paste and rings around the stoma
• C. Clean the area daily with soap and water before applying bag
• D. Apply talcum powder twice a day

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

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