Nursing Elites

1. You notice that Miss Kate, a bread vendor, receives and changes money, then holds the bread without washing her hands. As a nurse, what should you say to Miss Kate?

• A. Miss, don't touch the bread, I'll be the one to pick it up.
• B. Miss, please wash your hands before you pick up the bread.
• C. Miss, use a pick-up forceps when picking up the bread.
• D. Miss, your hands are dirty, I guess I'll try another bread shop.

Correct answer: B

Rationale: The correct answer is B, as it emphasizes the importance of hygiene in food handling, which is crucial to prevent the spread of germs and diseases. The other options do not address the root of the issue, which is the unhygienic handling of food. Option A avoids direct confrontation but does not educate the vendor on proper hygiene. Option C, although it suggests a hygienic method, may not be practical or available in all situations. Option D is an avoidance strategy rather than a way to address the problem.

2. A client with chronic kidney disease is being taught about dietary needs by a nurse. Which of the following foods should the nurse identify as being the lowest in phosphorus?

• A. Medium apple
• B. Bran cereal
• C. Scrambled eggs
• D. Ground turkey

Correct answer: A

Rationale: The correct answer is A, a medium apple. Apples are a suitable option for clients with chronic kidney disease as they are low in phosphorus. Bran cereal (choice B), scrambled eggs (choice C), and ground turkey (choice D) are all higher in phosphorus content compared to apples, making them less ideal choices for individuals with chronic kidney disease.

3. What are sheets/forms that provide an efficient and time-saving way to record information that must be obtained repeatedly at regular and/or short intervals of time? This does not replace progress notes; instead, it records information on vital signs, intake and output, treatment, postoperative care, postpartum care, and diabetic regimen, etc. These are used whenever specific measurements or observations need to be documented repeatedly. What is this?

• A. Nursing Kardex
• B. Graphic Flow Sheets
• C. Discharge Summary
• D. Medicine and Treatment Record

Correct answer: A

Rationale: The correct answer is A, Nursing Kardex. Nursing Kardex is a tool used for documenting essential patient information that needs to be recorded repeatedly at regular intervals. It includes vital signs, intake and output, treatment details, postoperative care, postpartum care, and diabetic regimen. This tool is efficient and time-saving for healthcare professionals. Choice B, Graphic Flow Sheets, may be used for visual representation of patient data but is not specifically designed for repeated documentation of essential information. Choice C, Discharge Summary, is a document outlining the patient's care and condition at the time of discharge, not for repeated recording of ongoing data. Choice D, Medicine and Treatment Record, focuses more on specific medications and treatments rather than a comprehensive recording of various patient data needed at regular intervals.

4. Nancy blames God for her situation. She is easily provoked to tears and wants to be left alone, refusing to eat or talk to her family. A religious person before, she now refuses to pray or go to church stating that God has abandoned her. The nurse understands that Nancy is grieving for her self and is in the stage of:

• A. bargaining
• B. denial
• C. anger
• D. acceptance

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

5. What nutrition-related side effect is most likely to occur after head and neck surgery for cancer treatment?

• A. Aspiration
• B. Acid reflux
• C. Dumping syndrome
• D. Diarrhea

Correct answer: A

Rationale: The most likely nutrition-related side effect after head and neck surgery for cancer treatment is aspiration. This is due to changes in swallowing mechanics, which can cause food or liquids to be inhaled into the lungs. While acid reflux, dumping syndrome, and diarrhea are potential side effects related to nutrition, they are not as directly connected to head and neck surgery. Acid reflux is more often related to issues with the lower esophageal sphincter, dumping syndrome is typically a complication of gastric surgery, and diarrhea can have various causes, including certain medications or gastrointestinal illnesses.

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