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. Diseases of the heart and blood vessels are collectively referred to as _____.

• A. Coronary artery disease
• B. Cardiovascular disease
• C. Coronary heart disease
• D. Coronary vessel disease

Correct answer: B

Rationale: The correct term for diseases of the heart and blood vessels is cardiovascular disease. While coronary artery disease (Choice A) specifically involves the narrowing of coronary arteries, it is just one type of cardiovascular disease. Coronary heart disease (Choice C) is also a specific condition related to the heart's blood vessels. Choice D, coronary vessel disease, is not a commonly used term to describe diseases of the heart and blood vessels. Therefore, Choice B, cardiovascular disease, is the most inclusive and appropriate term to refer to these conditions.

3. A nurse is teaching a parent about appropriate snack choices for her 9-month-old infant. Which of the following food choices should the nurse recommend?

• A. Skim milk
• B. Unsalted popcorn
• C. Graham crackers
• D. Raw carrots

Correct answer: C

Rationale: Graham crackers are an appropriate snack choice for a 9-month-old infant due to their texture and ease of consumption. Skim milk (Choice A) is not recommended for infants under 1 year old due to the potential risk of developing milk allergies. Unsalted popcorn (Choice B) can be a choking hazard for infants. Raw carrots (Choice D) are a potential choking hazard for a 9-month-old infant and may be difficult for them to chew and digest.

4. In any event of an adverse hemolytic reaction during blood transfusion, Nursing intervention should focus on:

• A. Slow the infusion, Call the physician and assess the patient
• B. Stop the infusion, Assess the client, Send the remaining blood to the laboratory and call the physician
• C. Stop the infusion, Call the physician and assess the client
• D. Slow the confusion and keep a patent IV line open for administration of medication

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. 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.

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