Nursing Elites

1. In taking the client’s blood pressure, the nurse should position the client’s arm:

• A. At the level of the heart
• B. Slightly above the level of the heart
• C. At the 5th intercostals space midclavicular line
• D. Below the level of the heart

Correct answer: A

Rationale: Proper patient positioning is essential for maximizing lung expansion and promoting the drainage of secretions. Postural drainage techniques rely on gravity to help clear different lung segments, which is critical in preventing complications such as atelectasis or pneumonia in immobilized patients.

2. Dina, 17 years old, asks you how a tubal ligation prevents pregnancy. Which would be the best answer?

• A. Prostaglandins released from the cut fallopian tubes can kill sperm
• B. Sperm cannot enter the uterus because the cervical entrance is blocked
• C. Sperm can no longer reach the ova, because the fallopian tubes are blocked
• D. The ovary no longer releases ova as there is nowhere for them to go

Correct answer: C

Rationale: The correct answer is C: 'Sperm can no longer reach the ova because the fallopian tubes are blocked.' Tubal ligation works by blocking the fallopian tubes, preventing sperm from reaching the egg for fertilization. Choice A is incorrect because prostaglandins are not released from the cut fallopian tubes to kill sperm. Choice B is incorrect as the cervical entrance being blocked does not relate to tubal ligation. Choice D is incorrect because tubal ligation does not affect the release of ova from the ovary.

3. Characteristics of type two diabetes include all of the following except:

• A. insulin resistance
• B. blood glucose levels that rise too high
• C. blood insulin levels that rise too high
• D. rapid destruction of the pancreas

Correct answer: D

Rationale: Type 2 diabetes is characterized by insulin resistance, high blood glucose levels, and high blood insulin levels. Rapid destruction of the pancreas is not a feature of this condition. The destruction of pancreatic beta cells is more commonly associated with type 1 diabetes, not type 2 diabetes. Therefore, option D is the correct answer. Options A, B, and C are all characteristic features of type 2 diabetes, making them incorrect choices.

4. What is the primary food safety concern for a patient undergoing chemotherapy?

• A. Possible food allergy reactions
• B. Possible food-drug interactions
• C. Possible pesticide residue
• D. Potential risk of foodborne illness

Correct answer: D

Rationale: The correct answer is D: Potential risk of foodborne illness. Patients undergoing chemotherapy have compromised immune systems, making them more susceptible to foodborne illnesses. Chemotherapy can reduce the count of white blood cells, which impairs the body's ability to fight off infections from bacteria or other pathogens that might be present in food. Therefore, the prevention of foodborne illnesses is a critical concern for these patients. Choices A, B, and C, while they represent valid concerns for food safety in general, are not the primary concern for patients undergoing chemotherapy. These patients are at a heightened risk of experiencing severe complications from foodborne illnesses, making it a more significant concern than potential food allergies, food-drug interactions, or pesticide residues.

5. A client who is postoperative following a liver transplant and weighs 65 kg. Which of the following actions should the nurse plan to take?

• A. Keep the client NPO for the first week postoperative.
• B. Limit caloric content once the client resumes eating.
• C. Stress the importance of safe food-handling practices.
• D. Decrease foods high in carbohydrates once the client resumes eating.

Correct answer: C

Rationale: After a liver transplant, it is crucial to stress the importance of safe food-handling practices to prevent foodborne illnesses, especially due to the client's altered immune system. Keeping the client NPO for the first week postoperative is not recommended as early nutrition support is essential for recovery. Limiting caloric content once the client resumes eating may not be appropriate as they need adequate nutrition for healing. Decreasing foods high in carbohydrates without a specific indication may lead to inadequate nutrient intake, which is not ideal for the client's recovery.

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