Nursing Elites

1. 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.

2. A nurse is planning care for a client who has ascites secondary to liver disease. Which of the following interventions should the nurse include in the plan of care?

• A. Reduce complex carbohydrates to 30% of total calories.
• B. Restrict protein intake to less than 0.8 g/kg/day.
• C. Decrease daily caloric intake by 20%.
• D. Limit sodium to 2000 mg or less per day.

Correct answer: D

Rationale: The correct answer is to limit sodium to 2000 mg or less per day. Ascites, which is the abnormal accumulation of fluid in the abdominal cavity, is commonly associated with liver disease. Limiting sodium intake helps manage fluid retention by reducing the fluid accumulation in the abdomen. Choices A, B, and C are incorrect because reducing complex carbohydrates, restricting protein intake, or decreasing caloric intake are not the primary interventions for managing ascites in liver disease.

3. The OR team performs distinct roles for one surgical procedure to be accomplished within a prescribed time frame and deliver a standard patient outcome. While the surgeon performs the surgical procedure, who monitors the status of the client like urine output, blood loss?

• A. Scrub Nurse
• B. Surgeon
• C. Anaesthesiologist
• D. Circulating Nurse

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

4. What differentiates one amino acid from another?

• A. The amine group
• B. The acid group
• C. The side chain
• D. None of the above

Correct answer: C

Rationale: The side chain, also known as the R group, is what differentiates one amino acid from another. It imparts unique properties to each amino acid, thereby influencing their roles and functions in proteins. The amine group (Choice A) and the acid group (Choice B) are components of all amino acids and do not cause the differences among various amino acids. Choice D is incorrect as it suggests that none of the given options account for the differences, which is not true as the side chain does.

5. How is an ear infection that persists for less than 14 days classified?

• A. Mastoiditis
• B. Chronic Ear Infection
• C. Acute Ear Infection
• D. Otitis Media

Correct answer: C

Rationale: Acute Ear Infection is the correct answer because it typically refers to an infection that is short-lived and often severe, typically lasting less than 14 days. Chronic Ear Infection (Choice B) is incorrect as it refers to an ear infection that lasts for a long time or recurs often, typically more than three months. Mastoiditis (Choice A) is a complication of a middle ear infection and not an ear infection itself. Otitis Media (Choice D) is a general term for inflammation or infection in the middle ear, which can be either acute or chronic, so it's not specific enough to be the correct answer. Understanding the duration and severity of symptoms can help in identifying the type of ear infection, facilitating appropriate treatment and prevention of complications.

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