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. If there is an accidental injury to the parathyroid gland during a thyroidectomy which of the following might Leda develop postoperatively?

• A. Cardiac arrest C. Respiratory failure
• B. Dyspnea D. Tetany
• C.
• D.

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.

3. What primarily determines the Dietary Reference Intake (DRI) for protein?

• A. Intake of fatty acids
• B. Gender
• C. Height
• D. Body weight

Correct answer: D

Rationale: The Dietary Reference Intake (DRI) for protein is primarily determined by an individual's body weight. This is because the body's protein requirement is proportionate to its size, which is generally reflected in the body weight. Therefore, choice D is correct. Choices A, B, and C are incorrect: While factors such as fatty acid intake, gender, and height can influence an individual's overall nutritional needs, they do not directly determine the DRI for protein.

4. What is the first thing you should do before sharing information with a patient?

• A. Provide background knowledge
• B. Ask for permission
• C. Remove personal protective equipment (PPE)
• D. Remind the patient that you are the authority

Correct answer: B

Rationale: Before sharing information with a patient, it is essential to ask for their permission. This action respects the patient's autonomy and encourages their participation in the learning process. Asking for permission establishes a foundation of trust and partnership between the healthcare provider and the patient. Providing background knowledge (Choice A) is important, but it should come after receiving consent to share information. Removing personal protective equipment (Choice C) is not related to the communication process. Reminding the patient that you are the authority (Choice D) is inappropriate as it can undermine the patient's autonomy and hinder effective communication in a patient-centered care approach.

5. If it is determined that a child is being physically abused by a parent, what would be the most important goal for the nurse to establish with the family?

• A. The child and any siblings will reside in a secure environment
• B. The family will feel at ease in their relationship with the counselor
• C. The family will gain insight into their abusive behavior patterns
• D. The mother will learn to apply verbal discipline with her children

Correct answer: A

Rationale: The primary objective when dealing with cases of child abuse is to ensure the safety of the child and any siblings. This means creating a secure environment free from harm, which is why choice 'A' is the correct answer. While choices 'B', 'C', and 'D' might be subsequent steps in a comprehensive plan to deal with the situation, they are not the immediate priority. Understanding abusive behavioral patterns or improving the relationship with the counselor will not directly lead to the child's safety. Likewise, teaching the mother to apply verbal discipline doesn't guarantee the child's safety if the abusive behavior continues. Therefore, these options are not the most important initial goal.

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