Nursing Elites

1. If it is determined that a child is being physically abused by a parent, what would be the most important goal for the nurse to establish with the family?

• A. The child and any siblings will reside in a secure environment
• B. The family will feel at ease in their relationship with the counselor
• C. The family will gain insight into their abusive behavior patterns
• D. The mother will learn to apply verbal discipline with her children

Correct answer: A

Rationale: The primary objective when dealing with cases of child abuse is to ensure the safety of the child and any siblings. This means creating a secure environment free from harm, which is why choice 'A' is the correct answer. While choices 'B', 'C', and 'D' might be subsequent steps in a comprehensive plan to deal with the situation, they are not the immediate priority. Understanding abusive behavioral patterns or improving the relationship with the counselor will not directly lead to the child's safety. Likewise, teaching the mother to apply verbal discipline doesn't guarantee the child's safety if the abusive behavior continues. Therefore, these options are not the most important initial goal.

2. A nurse is initiating continuous enteral feedings for a client who has a new gastrostomy tube. Which of the following actions should the nurse take?

• A. Measure the client’s gastric residual every 12 hours.
• B. Obtain the client’s electrolyte levels every 4 hours.
• C. Keep the client’s head elevated at 15° during feedings.
• D. Flush the client’s tube with 30 mL of water every 4 hours.

Correct answer: D

Rationale: Flushing the client’s tube with 30 mL of water every 4 hours is essential to maintain tube patency and prevent blockages. This action helps ensure the continuous flow of enteral feedings without obstruction. Measuring the client’s gastric residual every 12 hours (Choice A) is important but not the priority when initiating enteral feedings. Obtaining the client’s electrolyte levels every 4 hours (Choice B) is unnecessary and not directly related to tube feeding initiation. Keeping the client’s head elevated at 15° during feedings (Choice C) is a good practice to prevent aspiration, but tube flushing is more crucial to prevent tube occlusion.

3. Each statement is true of calcium within saliva, except one. Which is the exception?

• A. Saliva is supersaturated with calcium.
• B. Saliva is a source of calcium to mineralize an immature or demineralized enamel surface.
• C. Calcium and phosphate in saliva provide a buffering action.
• D. Calcium within saliva increases dental caries.

Correct answer: D

Rationale: The correct answer is D. Calcium within saliva does not increase dental caries; in fact, the buffering action provided by calcium and phosphate in saliva inhibits caries formation by preventing the dissolution of enamel by plaque biofilm. Choice A is correct as saliva is indeed supersaturated with calcium. Choice B is correct as saliva serves as a source of calcium to mineralize an immature or demineralized enamel surface. Choice C is correct as calcium and phosphate in saliva do provide a buffering action to protect teeth from acids.

4. Is the loss of teeth or supporting periodontium often associated with poor food selection and limited chewing ability, and do the patients' masticatory efficiency and biting force decline with each tooth lost?

• A. Both statements are true
• B. Both statements are false
• C. The first statement is true; the second is false
• D. The first statement is false; the second is true

Correct answer: A

Rationale: Both statements are indeed true. The loss of teeth or supporting periodontium frequently leads to poor food selection and limited chewing ability, as these conditions can make certain foods difficult to consume. Additionally, a patient's masticatory efficiency and biting force do decline with each tooth lost, as there are fewer teeth to distribute the force of the bite. Choices B, C, and D are incorrect because they suggest that one or both of these statements are false, which is not the case.

5. What instruction should the nurse include on weight gain during pregnancy?

• A. Failure to obtain the required weight gain during pregnancy will increase the risk of preterm birth.
• B. An obese client needs to gain as much weight as a client with a normal body mass index.
• C. A client with a normal body mass index should plan on gaining 50 pounds.
• D. Clients will need to eat for two when they are pregnant.

Correct answer: A

Rationale: Appropriate weight gain is crucial for reducing the risk of preterm birth.

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