Nursing Elites

1. 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.

2. For an incontinent elderly client who frequently wets his bed and develops redness and skin excoriation at the perianal area, what is the best nursing goal?

• A. Ensure that the bed linen is always dry
• B. Frequently check the bed for wetness and keep it dry
• C. Place a rubber sheet under the client's buttocks
• D. Keep the patient clean and dry

Correct answer: A

Rationale: The best nursing goal for an incontinent elderly client with skin excoriation is to ensure that the bed linen is always dry. This helps in preventing further skin breakdown and promoting skin integrity. Choice B, to frequently check the bed for wetness and keep it dry, may not address the issue of prevention if the linen is not consistently dry. Choice C, placing a rubber sheet under the client's buttocks, focuses more on protecting the mattress rather than addressing the client's skin condition directly. Choice D, keeping the patient clean and dry, is important but does not specifically address the preventive aspect of maintaining dry bed linen.

3. Nurse Edna thinks that the patient is somewhat like his father. She then identifies positive feeling for the patient that affects the objectivity of her nursing care. This emotional reaction is called:

• A. Transference
• B. Counter Transference
• C. Reaction formation
• D. Sympathy

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

4. Can bacterial plaque metabolize sucrose, lactose, and fructose? Is fructose, also known as levulose and found naturally in honey, less cariogenic than sucrose and lactose?

• A. Yes, bacterial plaque can metabolize these sugars, but no, fructose is not less cariogenic.
• B. No, bacterial plaque cannot metabolize these sugars, and fructose is not less cariogenic.
• C. Yes, bacterial plaque can metabolize these sugars, but no, fructose is not less cariogenic.
• D. No, bacterial plaque cannot metabolize these sugars, but yes, fructose is less cariogenic.

Correct answer: A

Rationale: The first statement is correct as bacterial plaque can indeed metabolize sucrose, lactose, and fructose. However, the second statement is inaccurate. Fructose, despite being found naturally in honey and known also as levulose, is not less cariogenic than either sucrose or lactose. This means that its consumption does not result in fewer cavities or tooth decay. Therefore, the correct answer is that bacterial plaque can metabolize these sugars, but fructose is not less cariogenic. Choices B, C, and D are incorrect because they either wrongly assert that bacterial plaque cannot metabolize these sugars or wrongly claim that fructose is less cariogenic.

5. What describes a common physical change of aging that can affect an older adult's nutrition?

• A. reduced salivary output
• B. increased gastrointestinal motility
• C. abnormal cortisol production
• D. increase in number of taste buds

Correct answer: A

Rationale: Reduced salivary output is a common physical change in aging. This can affect an older adult's nutrition by impacting chewing, swallowing, and taste perception. The decrease in saliva production can make it harder to chew and swallow food effectively, affecting the overall eating experience. Additionally, saliva plays a role in taste perception, so a reduction in salivary output can lead to alterations in how food tastes, potentially impacting an individual's appetite and food choices. Increased gastrointestinal motility (choice B) is not typically associated with aging and would not directly affect nutrition. Abnormal cortisol production (choice C) is related to hormonal changes and is not a common physical change of aging that affects nutrition. An increase in the number of taste buds (choice D) is not a typical change associated with aging and would not have a significant impact on an older adult's nutrition.

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