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. What is the most significant dietary influence on the development of dental caries?

• A. Carbohydrates
• B. Vitamins
• C. Minerals
• D. Fats

Correct answer: A

Rationale: The correct answer is A: Carbohydrates. Carbohydrates, especially fermentable sugars, are the most significant dietary factor in the development of dental caries. When these sugars are consumed, they can be fermented by bacteria in the mouth, leading to the production of acids. These acids lower the pH in the mouth, creating an acidic environment that promotes demineralization of the tooth enamel, ultimately causing dental caries. Choices B, C, and D are incorrect because while vitamins and minerals are important for overall health, they do not have the same direct impact on the development of dental caries as fermentable carbohydrates do. Fats, on the other hand, do not play a significant role in the development of dental caries.

3. A nurse is caring for an older adult client who reports difficulty chewing due to ill-fitting dentures. Which of the following foods should the nurse recommend for the client?

• A. Dried fruit
• B. Roast beef
• C. Tuna fish
• D. Apple slices

Correct answer: C

Rationale: The correct answer is C: Tuna fish. Tuna fish is a soft and easy-to-chew option, suitable for clients with ill-fitting dentures. Dried fruit (choice A) can be tough to chew and may stick to the dentures, causing discomfort. Roast beef (choice B) requires significant chewing effort and may not be suitable for someone with difficulty chewing. Apple slices (choice D) are crunchy and hard, which can be challenging for individuals with ill-fitting dentures.

4. The nurse is working with a patient who recently had a stroke. The patient frequently chokes and coughs when eating and is having difficulty feeding herself. What is the best way to ensure adequate nutrition?

• A. to have an aide feed her at each meal
• B. to ask a family member to assist during meals
• C. to provide tube feedings for the patient
• D. to initiate TPN for the patient

Correct answer: C

Rationale: The best way to ensure adequate nutrition for a stroke patient who frequently chokes and coughs when eating and has difficulty feeding herself is to provide tube feedings. Tube feedings are a safe and effective method to deliver nutrition directly to the stomach or intestines, bypassing the swallowing mechanism, reducing the risk of aspiration. Having an aide feed her each meal (choice A) may not address the underlying issue of swallowing difficulty and aspiration risk. Asking a family member to be present at each meal (choice B) does not provide a definitive solution to the patient's nutritional needs. Placing the patient on total parenteral nutrition (TPN) (choice D) is a more invasive and typically reserved for patients who cannot tolerate enteral feedings or have non-functional gastrointestinal tracts.

5. Which type of immunity is demonstrated by the transfer of a mother's immunoglobulin across the placenta to protect the child?

• A. Natural active immunity
• B. Natural passive immunity
• C. Artificial active immunity
• D. Artificial passive immunity

Correct answer: B

Rationale: The immunoglobulin passed from the mother to the child through the placenta is an example of natural passive immunity, making choice B the correct answer. This transfer gives the child temporary immunity to various diseases without their immune system having to work. On the other hand, natural active immunity (Choice A) occurs when the body produces its own antibodies in response to an antigen. Artificial active immunity (Choice C) is achieved through vaccinations, where the immune system is stimulated to produce antibodies against a specific disease. Artificial passive immunity (Choice D) is a temporary immunity that involves the transfer of pre-formed antibodies from another source.

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