Nursing Elites

1. In which type of shock does the patient experience a mismatch of blood flow to the cells?

• A. Distributive
• B. Cardiogenic
• C. Hypovolemic
• D. Septic

Correct answer: A

Rationale: The correct answer is A: Distributive shock. Distributive shock is characterized by a widespread increase in vascular permeability leading to a relative hypovolemia and a mismatch of blood flow to the cells. Choice B, Cardiogenic shock, is due to the heart's inability to pump effectively. Choice C, Hypovolemic shock, results from a decrease in intravascular volume. Choice D, Septic shock, is caused by a systemic response to infection.

2. This study, which is an in-depth study of one boy, is a:

• A. case study
• B. longitudinal study
• C. cross-sectional study
• D. evaluative study

Correct answer: A

Rationale: The correct answer is 'A: case study.' A case study involves an in-depth examination of a single individual, group, or event. In this scenario, focusing on one boy aligns with the definition of a case study. The other options are not applicable: B) A longitudinal study involves following subjects over a period of time, C) A cross-sectional study examines a population at a single point in time, and D) An evaluative study assesses the effectiveness of a program or intervention, which is not the focus of the given scenario.

3. Mario listens to Richard’s bilateral sounds and finds that congestion is in the upper lobes of the lungs. The appropriate position to drain the anterior and posterior apical segments of the lungs when Mario does percussion would be:

• A. Client lying on his back then flat on his abdomen on Trendelenburg position
• B. Client seated upright in bed or on a chair then leaning forward in sitting position then flat on his back and on his
• C. Client lying flat on his back and then flat on his abdomen
• D. Client lying on his right then left side on Trendelenburg position

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.

4. Tony is to be discharged in the afternoon of the same day after tonsillectomy and adenoidectomy. You, as the RN, will make sure that the family knows to:

• A. offer pureed foods
• B. offer soft foods for a week to minimize discomfort while swallowing
• C. supplement his diet with Vitamin C-rich foods to enhance healing
• D. offer clear liquids for 3 days to prevent irritation

Correct answer: B

Rationale: After tonsillectomy and adenoidectomy, it is crucial to provide soft foods for a week to minimize discomfort while swallowing. This helps prevent irritation to the surgical site and allows for easier healing. Offering pureed foods (Choice A) may not be necessary as soft foods are usually sufficient. While Vitamin C is beneficial for healing, it is not necessary to supplement it immediately after surgery with Vitamin C-rich juices (Choice C). Clear liquids are typically recommended before surgery and not after, as the focus shifts to soft foods to aid in recovery, making Choice D incorrect.

5. A client has a small-bore jejunostomy and is receiving a continuous tube feeding with a high-viscosity formula. Which of the following actions should the nurse take to prevent the tubing from clogging?

• A. Replace the bag and tubing every 24 hours
• B. Flush the tubing with 10 mL water every 6 hours
• C. Administer the feeding by gravity drip
• D. Heat the formula prior to infusion

Correct answer: B

Rationale: To prevent clogging when using high-viscosity formulas in a small-bore jejunostomy, the nurse should flush the tubing with 10 mL of water every 6 hours. This action helps maintain tube patency and prevent blockages. Replacing the bag and tubing every 24 hours (Choice A) is unnecessary and does not specifically address preventing clogging. Administering the feeding by gravity drip (Choice C) or heating the formula prior to infusion (Choice D) are not effective interventions for preventing tubing clogging.

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