Nursing Elites

1. The nurse is assessing a client with a new diagnosis of Listeria food poisoning. What action should the nurse take first?

• A. Educate the client on safe food practices.
• B. Start a traceback to identify the source of the outbreak.
• C. Report the case to the county board of health.
• D. Ask the client if they have consumed any unpasteurized products.

Correct answer: D

Rationale: The correct first action for the nurse to take when assessing a client with a new diagnosis of Listeria food poisoning is to inquire if the client has consumed any unpasteurized products. This is crucial because Listeria contamination is often associated with unpasteurized dairy products and undercooked meats. Educating the client on safe food practices (Choice A) is important but not the priority at this initial assessment stage. Starting a traceback to identify the source of the outbreak (Choice B) and reporting the case to the county board of health (Choice C) are necessary actions but should come after gathering information directly from the client regarding potential exposure to high-risk foods.

2. 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.

3. During which phase of the therapeutic relationship should the nurse inform the patient about the termination of therapy?

• A. Pre-orientation
• B. Orientation
• C. Working
• D. Termination

Correct answer: D

Rationale: The correct answer is 'Termination'. This phase of the therapeutic relationship is when the nurse informs the patient about the conclusion of therapy. It is during this phase that the nurse and the patient review the goals and progress made and also discuss the upcoming termination. The other phases are not the appropriate times for discussing termination. 'Pre-orientation' is the phase before the nurse-patient relationship is established; 'Orientation' is when the nurse and patient get to know each other and set goals; and 'Working' is when these goals are pursued. Therefore, choices A, B, and C are incorrect.

4. Legally, Patients chart are:

• A. Owned by the government since it is a legal document
• B. Owned by the doctor in charge and should be kept from the administrator for whatever reason
• C. Owned by the hospital and should not be given to anyone who request it other than the doctor in charge
• D. Owned by the patient and should be given by the nurse to the client as requested

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

5. Which outcome has been shown to be most closely associated with breastfeeding infants of mothers who smoke?

• A. poor temperature regulation
• B. vision impairment
• C. vomiting
• D. elevated blood pressure

Correct answer: C

Rationale: The correct answer is C: vomiting. Infants breastfed by mothers who smoke are more likely to experience vomiting and gastrointestinal issues due to the transfer of nicotine and other harmful substances through breast milk. Choices A, B, and D are incorrect. Poor temperature regulation, vision impairment, and elevated blood pressure are not the primary outcomes closely associated with breastfeeding infants of mothers who smoke.

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