Nursing Elites

1. The purpose of chest percussion and vibration is to loosen secretions in the lungs. The difference between the procedures is:

• A. Percussion uses only one hand, while vibration uses both hands
• B. Percussion delivers cushioned blows to the chest with cupped palms, while vibration gently shakes secretions loose
• C. In both percussion and vibration, the hands are not on top of each other, and hand action is not in tune with the client's breath
• D. Percussion slaps the chest to loosen secretions, while vibration shakes the secretions along with the inhalation

Correct answer: D

Rationale: Chest percussion involves the use of rhythmic tapping to dislodge mucus from the lungs, facilitating its movement toward the larger airways where it can be expelled. This technique is particularly important in conditions where mucus retention is a significant risk factor for infection. The key difference between chest percussion and vibration is that percussion involves slapping the chest to loosen secretions, while vibration involves shaking the secretions along with the inhalation, aiding in moving the loosened secretions upwards for easier removal. Choices A, B, and C do not accurately describe the main difference between chest percussion and vibration, making them incorrect.

2. What is the most common type of kidney stone?

• A. Cystine
• B. Calcium
• C. Struvite
• D. Uric acid

Correct answer: B

Rationale: The most common type of kidney stone is calcium-based, specifically calcium oxalate. This is usually due to high calcium levels in the urine, which can be caused by dietary factors or certain metabolic disorders. Cystine stones, on the other hand, are less common and occur in individuals with a hereditary disorder leading to excessive excretion of certain amino acids. Struvite stones are often formed in response to an infection. Uric acid stones may occur in individuals who do not consume sufficient fluids or who lose too much fluid, among other factors. Therefore, while all these substances can form stones in the kidneys, calcium stones are the most common.

3. What is considered fast breathing in a 13-month-old child if the respiratory rate (RR) exceeds which value?

• A. 40 breaths per minute
• B. 50 breaths per minute
• C. 60 breaths per minute
• D. 30 breaths per minute

Correct answer: C

Rationale: In the context of pediatric care, a respiratory rate of more than 60 breaths per minute in a child aged 13 months is considered fast breathing, hence option 'C' is correct. Options 'A', 'B', and 'D' are incorrect as they do not meet the specified criteria for fast breathing in a 13-month-old. Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, including monitoring respiratory rates, to ensure that interventions are appropriately targeted and outcomes are optimized.

4. Which food items should be avoided by a child with lactose intolerance?

• A. Popcorn, seeds, and any foods containing nuts.
• B. Milk, cheese, ice cream, and puddings.
• C. Wheat, rye, barley, and commercially baked goods.
• D. Eggs, ham, bacon, and canned meats.

Correct answer: B

Rationale: The correct answer is B: Milk, cheese, ice cream, and puddings should be avoided by a child with lactose intolerance because they contain lactose, which the child's body may have difficulty digesting. Option A is incorrect as popcorn, seeds, and foods containing nuts do not typically contain lactose. Option C lists wheat, rye, barley, and commercially baked goods, which are sources of gluten, not lactose. Option D includes eggs, ham, bacon, and canned meats, which are also not sources of lactose. Therefore, B is the most appropriate choice for a child with lactose intolerance.

5. Which type of nutritional deficiency results from inadequate absorption?

• A. Unmeasurable
• B. Primary deficiency
• C. Secondary deficiency
• D. Codependent

Correct answer: C

Rationale: The correct answer is C: Secondary deficiency. A nutritional deficiency resulting from decreased intake is called a primary deficiency. On the other hand, a secondary deficiency refers to a vitamin deficiency caused by inadequate absorption or use, increased requirements, excretion, or destruction. Choice A, 'Unmeasurable,' is incorrect as it does not describe a type of nutritional deficiency. Choice B, 'Primary deficiency,' is incorrect as it refers to a deficiency caused by decreased intake, not inadequate absorption. Choice D, 'Codependent,' is incorrect as it is unrelated to the context of nutritional deficiencies.

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