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. For a patient with celiac disease, which dietary modification is necessary?

• A. Increase protein intake
• B. Avoid gluten
• C. Increase dairy intake
• D. Avoid lactose

Correct answer: B

Rationale: The correct answer is B: Avoid gluten. Patients with celiac disease have an immune reaction to gluten, a protein found in wheat, barley, and rye. Therefore, it is crucial for individuals with celiac disease to avoid gluten-containing products. Increasing protein intake (Choice A) is not specifically necessary for celiac disease management. Increasing dairy intake (Choice C) is unrelated to the dietary requirements of individuals with celiac disease. Avoiding lactose (Choice D) is relevant for individuals with lactose intolerance, not celiac disease. Therefore, the only necessary modification for a patient with celiac disease is to avoid gluten.

3. A breastfeeding mother complains that she missed her son's last two feedings and now her breasts have become full, hard, and uncomfortable. This condition is known as _____.

• A. mastitis
• B. engorgement
• C. letdown
• D. galactorrhea

Correct answer: B

Rationale: Engorgement occurs when the breasts become overly full, leading to discomfort and sometimes difficulty with latching. It can be relieved by feeding or expressing milk. Mastitis, choice A, is characterized by breast inflammation usually caused by an infection. Letdown, choice C, refers to the release of milk from the breast. Galactorrhea, choice D, is the spontaneous flow of milk from the breast unassociated with childbirth or nursing.

4. Which of the following is a factor that affects Basal Metabolic Rate (BMR)?

• A. Age
• B. Sleep
• C. Fasting/Starvation
• D. All of the above

Correct answer: D

Rationale: All the listed options (Age, Sleep, Fasting/Starvation, Activity Level) are factors that can affect a person's Basal Metabolic Rate (BMR). BMR is the number of calories your body needs to accomplish its most basic (basal) life-sustaining functions. Age can affect BMR as metabolism slows with age. Sleep can influence BMR as metabolism slows during sleep. Fasting or starvation can decrease BMR as the body conserves energy. Activity level can also influence BMR; the more active you are, the higher your BMR, as your body requires more energy for physical activities.

5. A nurse is reinforcing dietary teaching with a client who has vitamin A deficiency. Which of the following food choices should the nurse recommend as the best source of vitamin A?

• A. 1 small baked sweet potato
• B. 1 cup avocado
• C. 1 cup green beans
• D. 1 large apple

Correct answer: A

Rationale: The correct answer is A. Sweet potatoes are rich in beta-carotene, which the body converts into vitamin A, essential for vision and immune function. Avocado (choice B) is a good source of healthy fats but not high in vitamin A. Green beans (choice C) are nutritious but not a significant source of vitamin A. Apples (choice D) are low in vitamin A compared to sweet potatoes.

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