Nursing Elites

1. All of the following are seen in a child with measles. Which one is not?

• A. Reddened eyes
• B. Coryza
• C. Pustule
• D. Cough

Correct answer: C

Rationale: Measles typically presents with symptoms like reddened eyes, coryza (inflammation of the mucous membrane in the nose), and cough. However, pustules are not a common symptom of measles. Pustules are more characteristic of conditions like chickenpox rather than measles. Understanding these distinctions is crucial for accurate diagnosis and appropriate treatment.

2. What symptoms would most likely be associated with a transient ischemic attack?

• A. confusion and difficulty speaking
• B. headache and blurred vision
• C. chest pain and pressure
• D. claudication and peripheral edema

Correct answer: A

Rationale: The correct answer is A: confusion and difficulty speaking. These symptoms are commonly associated with a transient ischemic attack (TIA), which is a temporary blockage of blood flow to the brain. Choice B, headache and blurred vision, are more indicative of other conditions such as migraines or eye problems. Choice C, chest pain and pressure, are more characteristic of cardiac issues like a heart attack. Choice D, claudication and peripheral edema, are typical of peripheral arterial disease and not typically seen in TIAs.

3. Diet therapy for Rudy, who has acute renal failure is low-protein, low potassium and low sodium. The nutrition instructions should include:

• A. Recommend protein of high biologic value like eggs, poultry and lean meats
• B. Encourage client to include raw cucumbers, carrot, cabbage, and tomatoes
• C. Allowing the client cheese, canned foods and other processed food
• D. Bananas, cantaloupe, orange and other fresh fruits can be included in the diet

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.

4. A client is on a 2,000-calorie American Diabetes Association (ADA) diet and substitutes whole milk with skim milk. Which of the following items can the client add to the oatmeal on his breakfast tray?

• A. One 1/8 teaspoon of salt
• B. One ounce of raisins
• C. One tablespoon of low-fat margarine
• D. One teaspoon of brown sugar

Correct answer: B

Rationale: The correct answer is one ounce of raisins. Raisins are a healthy option to add to oatmeal as they provide natural sweetness without added sugars. They are a good source of fiber and essential nutrients. Option A, one 1/8 teaspoon of salt, is not necessary for flavoring oatmeal. Option C, one tablespoon of low-fat margarine, may add unnecessary fat to the meal. Option D, one teaspoon of brown sugar, adds extra sugar, which should be limited in a diabetes-friendly diet.

5. The nurse is working with a patient who recently had a stroke. The patient frequently chokes and coughs when eating and is having difficulty feeding herself. What is the best way to ensure adequate nutrition?

• A. to have an aide feed her at each meal
• B. to ask a family member to assist during meals
• C. to provide tube feedings for the patient
• D. to initiate TPN for the patient

Correct answer: C

Rationale: The best way to ensure adequate nutrition for a stroke patient who frequently chokes and coughs when eating and has difficulty feeding herself is to provide tube feedings. Tube feedings are a safe and effective method to deliver nutrition directly to the stomach or intestines, bypassing the swallowing mechanism, reducing the risk of aspiration. Having an aide feed her each meal (choice A) may not address the underlying issue of swallowing difficulty and aspiration risk. Asking a family member to be present at each meal (choice B) does not provide a definitive solution to the patient's nutritional needs. Placing the patient on total parenteral nutrition (TPN) (choice D) is a more invasive and typically reserved for patients who cannot tolerate enteral feedings or have non-functional gastrointestinal tracts.

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