Nursing Elites

1. After bronchoscopy, the nurse's priority is to check which of the following before feeding?

• A. Gag reflex
• B. Wearing off of anesthesia
• C. Swallowing reflex
• D. Peristalsis

Correct answer: A

Rationale: After a bronchoscopy procedure, the nurse's priority is to check the patient's gag reflex before allowing them to eat to prevent aspiration. The gag reflex helps protect the airway by triggering a cough or gag response if something touches the back of the throat. This is crucial to ensure that the patient can protect their airway and prevent food or fluids from entering the lungs, especially when the throat may be sensitive or compromised post-bronchoscopy. Checking for the wearing off of anesthesia, swallowing reflex, or peristalsis are important assessments but not the immediate priority before feeding in this context.

2. A client with frequent kidney stones is receiving dietary teaching from a nurse. Which of the following instructions should the nurse include?

• A. Limit your intake of dairy products.
• B. Increase your consumption of protein-rich foods.
• C. Avoid eating tree nuts, such as almonds.
• D. Take a vitamin C supplement twice daily.

Correct answer: A

Rationale: The correct answer is to instruct the client to limit their intake of dairy products. Dairy products are high in calcium and can contribute to kidney stone formation in susceptible individuals. Increasing protein intake may lead to higher excretion of calcium, which can exacerbate kidney stone formation. While tree nuts are high in oxalates, which can contribute to kidney stone formation, it is not the primary concern in this case. Vitamin C supplements can increase oxalate levels in the urine, potentially increasing the risk of kidney stone formation, so it should not be recommended.

3. You are on duty in the medical ward. You were asked to check the narcotics cabinet. You found out that what is on record does not tally with the drugs used. What will you do first?

• A. Write an incident report and refer the matter to the nursing director
• B. Keep your findings to yourself
• C. Report the matter to your supervisor
• D. Find out from the endorsement any patient who might have been given narcotics

Correct answer: C

Rationale: In this situation, the first step should be to report the matter to your supervisor. It is essential to notify the appropriate authority immediately to address the discrepancy in the narcotics cabinet. Choice A is not the first step as reporting to the nursing director should follow after informing the supervisor. Keeping the findings to yourself (Choice B) is not appropriate as it may jeopardize patient safety and is against ethical standards. While finding out which patient received narcotics (Choice D) is important, it is not the immediate action to take in this scenario.

4. Which two dietary components may help decrease blood cholesterol levels?

• A. Omega-3 fatty acids and soluble fiber
• B. Short-chain fatty acids and insoluble fiber
• C. Trans fatty acids and potassium
• D. Cis fatty acids and calcium

Correct answer: A

Rationale: The correct answer is A: Omega-3 fatty acids and soluble fiber. Omega-3 fatty acids are known to reduce triglycerides, while soluble fiber helps to lower LDL cholesterol levels. Both of these components are beneficial in managing blood cholesterol levels. Choice B, short-chain fatty acids and insoluble fiber, is incorrect as they do not have the same cholesterol-lowering effects as omega-3 fatty acids and soluble fiber. Choice C, trans fatty acids and potassium, is incorrect as trans fatty acids can raise LDL cholesterol levels and increase the risk of heart disease. Choice D, cis fatty acids and calcium, is incorrect as cis fatty acids are common in natural fats and do not specifically help in reducing blood cholesterol levels.

5. Which of the following statements are correct?

• A. Lipids are transported in the blood as lipoproteins, which are clusters of lipids associated with proteins.
• B. In type II diabetes, the pancreas produces insulin, but cells are resistant to this signal.
• C. The glycemic index classifies foods based on their potential to raise blood glucose levels.
• D. All of the above

Correct answer: D

Rationale: Option A is correct because lipoproteins indeed transport lipids in the blood. They are complexes of lipids and proteins that transport water-insoluble lipids through the blood. Option B is correct as it accurately describes the condition of type II diabetes where the pancreas can produce insulin, but the cells are resistant to its signal, causing an ineffective regulation of blood sugar. Option C is also correct because the glycemic index is indeed a classification system for foods based on their potential to raise blood glucose levels. High glycemic index foods raise blood glucose levels faster than low glycemic index foods. Hence, all the statements are correct, making option D the correct answer.

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