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. A nurse is caring for a client following an appendectomy. The nurse verifies the postoperative prescription which reads, 'Discontinue NPO status; advance diet as tolerated.' Which of the following are appropriate for the nurse to offer the client? (SATA)

• A. Wheat toast
• B. Applesauce
• C. Applesauce, Chicken broth
• D. Chicken broth

Correct answer: C

Rationale: The correct answer is C: Applesauce and chicken broth. After an appendectomy, patients are typically started on a clear liquid diet before advancing to more solid foods. Applesauce and chicken broth are part of a low-residue diet that is easily digestible and gentle on the digestive system, making them suitable choices for a client following surgery. Wheat toast may be too heavy and fibrous initially, while other solid foods should be introduced gradually to prevent gastrointestinal upset.

3. A client who underwent surgical placement of a colostomy is being cared for by a nurse. Which of the following statements indicates the client understands the dietary teaching?

• A. "Eating yogurt can help decrease the amount of gas that I have."?
• B. "I should eliminate pasta from my diet so that I don't have as many loose stools."?
• C. "My largest meal of the day should be in the evening."?
• D. "Carbonated beverages can help control odor."?

Correct answer: D

Rationale: The correct answer is D. Carbonated beverages can help control odor in clients with colostomies. This is because carbonated drinks can help decrease odor by reducing the production of odoriferous compounds in the colon. Choices A, B, and C are incorrect. Eating yogurt may help regulate bowel movements but does not specifically address odor control associated with colostomies. Eliminating pasta from the diet to reduce loose stools is not necessary for colostomy care. The timing of the largest meal of the day is not directly related to dietary teaching for colostomy care.

4. Which type of medication is most likely to induce xerostomia?

• A. Antibiotics
• B. Diuretics
• C. Local anesthetics
• D. Anticholinergics

Correct answer: D

Rationale: The correct answer is D, Anticholinergics. Anticholinergic medications commonly cause xerostomia by inhibiting saliva production, leading to dry mouth. Antibiotics (choice A) are not typically associated with xerostomia. Diuretics (choice B) increase urine production but do not directly affect saliva production. Local anesthetics (choice C) are used to numb specific areas during dental procedures and do not induce xerostomia.

5. A patient who reports stomach ulcers should avoid all the following foods, except one. Which is the exception?

• A. Proteins
• B. Caffeine
• C. Calcium
• D. Wheat

Correct answer: D

Rationale: Patients with stomach ulcers are advised to avoid foods that can increase stomach acid levels, such as caffeine, proteins, and calcium. Wheat, on the other hand, is generally well-tolerated by individuals with ulcers as it does not stimulate gastric secretions. Therefore, the correct answer is D. Choice A (Proteins), B (Caffeine), and C (Calcium) are not recommended for patients with stomach ulcers due to their potential to exacerbate symptoms.

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