Nursing Elites

1. 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.

2. Cariogenic foods and beverages, which are fermentable carbohydrates that can be metabolized by oral bacteria, reduce salivary pH to what critical level?

• A. 5
• B. 5.5
• C. 6
• D. 6.5

Correct answer: B

Rationale: Cariogenic foods and beverages lower the pH level in the mouth to below 5.5. This is a critical threshold, as it is the point at which enamel begins to demineralize, increasing the risk of dental caries. Therefore, options 'A', 'C', and 'D' are incorrect. Although a pH level of 5, as suggested by option 'A', would indeed lead to demineralization, it's not the threshold value. The pH levels suggested by options 'C' and 'D' (6 and 6.5, respectively) are higher than the critical value of 5.5, which means they would not initiate enamel demineralization and the subsequent risk of dental caries.

3. The nurse is assessing a client with a new diagnosis of Listeria food poisoning. What action should the nurse take first?

• A. Educate the client on safe food practices.
• B. Start a traceback to identify the source of the outbreak.
• C. Report the case to the county board of health.
• D. Ask the client if they have consumed any unpasteurized products.

Correct answer: D

Rationale: The correct first action for the nurse to take when assessing a client with a new diagnosis of Listeria food poisoning is to inquire if the client has consumed any unpasteurized products. This is crucial because Listeria contamination is often associated with unpasteurized dairy products and undercooked meats. Educating the client on safe food practices (Choice A) is important but not the priority at this initial assessment stage. Starting a traceback to identify the source of the outbreak (Choice B) and reporting the case to the county board of health (Choice C) are necessary actions but should come after gathering information directly from the client regarding potential exposure to high-risk foods.

4. A client receiving chemotherapy treatments tells the nurse, 'I feel so nauseated after my treatments.' Which of the following instructions should the nurse provide the client?

• A. Eat common foods that are served cold.
• B. Sip fluids slowly throughout the day.
• C. Sit up for 1 hr after eating meals.
• D. All of the Above

Correct answer: D

Rationale: The correct answer is D, 'All of the Above.' Common foods served cold, sipping fluids slowly throughout the day, and sitting up for 1 hr after eating meals can help manage nausea associated with chemotherapy. Eating common foods served cold can be easier on the stomach, sipping fluids slowly can prevent overwhelming the digestive system, and sitting up after meals can aid digestion. Choices A, B, and C all contribute to alleviating nausea and are appropriate instructions for the client.

5. By the age of three, which age-appropriate food skill can a child typically perform?

• A. Using utensils and a napkin
• B. Spearing food with a fork
• C. Measuring liquids
• D. Displaying proper table manners

Correct answer: B

Rationale: By the age of three, a child typically develops the motor skills needed to spear food with a fork. This is a critical milestone in self-feeding as it shows progress in fine motor coordination. Choice 'A' is incorrect because using utensils and a napkin properly is a skill that may take longer to develop and refine. Choice 'C' is not correct as measuring liquids requires a higher level of motor skills and understanding of quantities that a three-year-old child might not possess. Choice 'D' is also incorrect as the proper display of table manners is a complex skill that is typically learned over a longer period and involves social and cultural norms.

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