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 end product of lipid digestion?

• A. fatty acid
• B. sucrose
• C. monosaccharide
• D. amino acid

Correct answer: A

Rationale: The correct answer is A, fatty acid. During the process of lipid digestion, triglycerides are broken down into fatty acids and glycerol. These end products are then absorbed into the bloodstream or lymphatic system for further processing. Choices B, C, and D are incorrect because sucrose is a disaccharide, monosaccharide is a simple sugar unit, and amino acid is a building block of proteins, not the end product of lipid digestion.

3. Each nonnutritive sweetener can be recommended to patients with phenylketonuria, except one. Which one is the exception?

• A. Cyclamate
• B. Acesulfame-K
• C. Saccharin
• D. Aspartame

Correct answer: D

Rationale: The correct answer is D, Aspartame. Aspartame contains phenylalanine, which is contraindicated for individuals with phenylketonuria (PKU), a genetic disorder that impairs phenylalanine metabolism. Therefore, patients with PKU should avoid aspartame. Choices A, B, and C (Cyclamate, Acesulfame-K, Saccharin) are considered safe for individuals with PKU as they do not contain phenylalanine and can be recommended as alternatives to sugar for these patients.

4. Myxedema coma is a life-threatening complication of long-standing and untreated hypothyroidism with one of the following characteristics.

• A. Hyperglycemia
• B. Hypothermia
• C. Hyperthermia
• D. Hypoglycemia

Correct answer: A

Rationale: Myxedema coma is associated with hypothermia, not hyperthermia. Therefore, the correct characteristic of myxedema coma is hypothermia. This condition is a medical emergency that requires prompt recognition and intervention to prevent serious complications. The presence of hyperglycemia is not a defining characteristic of myxedema coma, making choice A the correct answer in this case. Hyperthermia and hypoglycemia are not typically seen in myxedema coma and are not consistent with the clinical presentation of this condition.

5. A nurse is assessing a client who reports muscle spasms in his calves and tingling in his hands. The client indicates consuming a low intake of milk products and green leafy vegetables. The nurse should identify that the client's findings indicate a deficiency in which of the following sources of nutrition?

• A. Iron
• B. Omega-3 fatty acids
• C. Vitamin C
• D. Calcium

Correct answer: D

Rationale: The correct answer is D, Calcium. Muscle spasms and tingling suggest a calcium deficiency, which is commonly associated with a low intake of milk products and green leafy vegetables. Iron (choice A) deficiency typically presents with fatigue and weakness, not muscle spasms and tingling. Omega-3 fatty acids (choice B) are essential for brain function and heart health, but their deficiency does not manifest as muscle spasms and tingling. Vitamin C (choice C) deficiency leads to scurvy with symptoms like bleeding gums and bruising, not muscle spasms and tingling.

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