Nursing Elites

1. Which factor contributes to the development of bone diseases in patients with Chronic Kidney Disease (CKD) due to retention?

• A. Iron
• B. Sodium
• C. Potassium
• D. Phosphorus

Correct answer: D

Rationale: The correct answer is phosphorus. Retention of phosphorus in patients with Chronic Kidney Disease (CKD) contributes to the development of bone disorders, including osteodystrophy, because it disrupts the balance of calcium and phosphorus in the body. This imbalance leads to a variety of bone diseases. The other options - iron, sodium, and potassium - while important in the overall metabolic function, are not directly linked to the development of bone diseases in CKD patients due to retention.

2. Which vitamin's recommended dietary allowance (RDA) is significantly increased during pregnancy?

• A. Folate
• B. Thiamine (B1)
• C. Riboflavin (B2)
• D. Niacin (B3)

Correct answer: A

Rationale: The correct answer is A: Folate. During pregnancy, the recommended dietary allowance (RDA) for folate is significantly increased to support fetal development and prevent neural tube defects and other congenital anomalies. Folate plays a crucial role in DNA synthesis and cell growth, making it essential for the rapidly dividing cells of the developing fetus. Thiamine (B1), Riboflavin (B2), and Niacin (B3) are important vitamins, but their RDAs do not undergo as significant an increase during pregnancy as folate's RDA does.

3. The purpose of chest percussion and vibration is to loosen secretions in the lungs. The difference between the procedures is:

• A. Percussion uses only one hand, while vibration uses both hands
• B. Percussion delivers cushioned blows to the chest with cupped palms, while vibration gently shakes secretions loose
• C. In both percussion and vibration, the hands are not on top of each other, and hand action is not in tune with the client's breath
• D. Percussion slaps the chest to loosen secretions, while vibration shakes the secretions along with the inhalation

Correct answer: D

Rationale: Chest percussion involves the use of rhythmic tapping to dislodge mucus from the lungs, facilitating its movement toward the larger airways where it can be expelled. This technique is particularly important in conditions where mucus retention is a significant risk factor for infection. The key difference between chest percussion and vibration is that percussion involves slapping the chest to loosen secretions, while vibration involves shaking the secretions along with the inhalation, aiding in moving the loosened secretions upwards for easier removal. Choices A, B, and C do not accurately describe the main difference between chest percussion and vibration, making them incorrect.

4. A nurse is providing teaching to the parent of a toddler about appropriate snacks. Which of the following foods should the nurse include?

• A. Sliced bananas
• B. Raw celery
• C. Peanut butter
• D. Grapes

Correct answer: A

Rationale: The correct answer is sliced bananas. Bananas are a good choice for toddlers as they are easy to chew, rich in potassium, and generally well-tolerated. Raw celery (Choice B) may pose a choking hazard due to its fibrous nature. Peanut butter (Choice C) should be avoided as it can also be a choking hazard and may cause an allergic reaction in some children. Grapes (Choice D) are a choking hazard for toddlers due to their size and shape, so they should be cut into smaller pieces or avoided altogether.

5. A nurse provides discharge instructions to a client about the food items that interact with warfarin effectiveness. Which food item indicates that the teaching was effective?

• A. Cauliflower
• B. Zucchini
• C. Green beans
• D. Broccoli

Correct answer: A

Rationale: Cauliflower is high in vitamin K, which can interact with warfarin.

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