Nursing Elites

1. In the hospital, when you need the medical record of a discharged patient for research you will request permission through:

• A. Doctor in charge
• B. The hospital director
• C. The nursing service
• D. Medical records section

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

2. For a client with a history of gout, which food should be included in their diet?

• A. Red meat
• B. Whole grains
• C. High-fat dairy
• D. Processed meats

Correct answer: B

Rationale: Whole grains are low in purines and are a better choice for someone with gout.

3. Each statement is true of swallowing and processing food, except one. Which is the exception?

• A. The swallowing reflex moves a bolus into the esophagus
• B. A bolus is a mass of food
• C. The bolus is transported to the stomach by osmosis and gravity
• D. The bolus penetrates the diaphragm through the esophageal hiatus

Correct answer: C

Rationale: The correct answer is C. The bolus is not transported to the stomach by osmosis and gravity, but by peristalsis. Peristalsis is the involuntary constriction and relaxation of muscles to push the bolus through the digestive system. Choices A, B, and D are correct statements. A bolus is indeed a mass of food, the swallowing reflex does move the bolus into the esophagus, and the bolus does not penetrate the diaphragm through the esophageal hiatus; instead, it enters the stomach through the lower esophageal sphincter.

4. Each is a characteristic manifestation of necrotizing ulcerative gingivitis (NUG), except one. Which is the exception?

• A. Gingival erythema
• B. Necrosis of interdental papilla
• C. Marasmus
• D. Metallic taste and foul odor

Correct answer: C

Rationale: The correct answer is C: Marasmus. Marasmus is a form of severe malnutrition and is not a direct manifestation of necrotizing ulcerative gingivitis (NUG). Choices A, B, and D are all characteristic manifestations of NUG. Gingival erythema, necrosis of interdental papilla, and metallic taste with foul odor are commonly associated with NUG due to the inflammatory and necrotic nature of the condition.

5. A nurse is caring for a client following a CVA and observes the client experiencing severe dysphagia. The nurse notifies the provider. Which of the following nutritional therapies will likely be prescribed?

• A. NPO until dysphagia subsides
• B. Supplements via nasogastric tube
• C. Initiation of total parenteral nutrition
• D. Soft residue diet

Correct answer: B

Rationale: In the scenario of severe dysphagia following a CVA, the client may have difficulty swallowing and require alternative nutritional support. Providing supplements via a nasogastric tube allows for the delivery of essential nutrients directly into the stomach, bypassing the swallowing difficulties. NPO (nothing by mouth) until dysphagia subsides may be too restrictive for the client's nutritional needs. Initiation of total parenteral nutrition is usually reserved for cases where enteral feeding is not possible or contraindicated. A soft residue diet may not be suitable for a client experiencing severe dysphagia.

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