Nursing Elites

1. Maternal malnutrition at a critical period of development may have lifelong effects on an individual's pattern of genetic expression and on the tendency to develop obesity, which is a concept known as _____.

• A. genetic determination
• B. metabolic tolerance
• C. chromosomal influence
• D. fetal programming

Correct answer: D

Rationale: Fetal programming refers to the concept that maternal nutrition during critical periods of development can have long-term effects on an individual's health and risk of diseases like obesity.

2. A client receiving chemotherapy treatments tells the nurse, 'I feel so nauseated after my treatments.' Which of the following instructions should the nurse provide the client?

• A. Eat common foods that are served cold.
• B. Sip fluids slowly throughout the day.
• C. Sit up for 1 hr after eating meals.
• D. All of the Above

Correct answer: D

Rationale: The correct answer is D, 'All of the Above.' Common foods served cold, sipping fluids slowly throughout the day, and sitting up for 1 hr after eating meals can help manage nausea associated with chemotherapy. Eating common foods served cold can be easier on the stomach, sipping fluids slowly can prevent overwhelming the digestive system, and sitting up after meals can aid digestion. Choices A, B, and C all contribute to alleviating nausea and are appropriate instructions for the client.

3. A nurse is providing teaching to a client with gastroesophageal reflux. Which of the following statements by the client indicates a need for further teaching?

• A. I should elevate the head of my bed while sleeping.
• B. I drink no more than 4 cups of coffee a day.
• C. I take my time when I am eating.
• D. I avoid foods and drinks made with chocolate.

Correct answer: B

Rationale: The correct answer is B: 'I drink no more than 4 cups of coffee a day.' Excessive coffee consumption can aggravate gastroesophageal reflux due to its acidic nature. Choices A, C, and D are all appropriate self-care measures for managing gastroesophageal reflux. Elevating the head of the bed while sleeping helps prevent acid reflux, eating slowly can reduce reflux episodes, and avoiding trigger foods like chocolate can help alleviate symptoms.

4. You are on morning duty in the medical ward. You have 10 patients assigned to you. During your endorsement rounds, you found out that one of your patients was not in bed. The patient next to him informed you that he went home without notifying the nurses. Which among the following will you do first?

• A. Make an incident report
• B. Call security to report the incident
• C. Wait for 2 hours before reporting
• D. Report the incident to your supervisor

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

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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