Nursing Elites

1. The purpose of the health history is to identify health-related considerations and medications that may cause nutritional risk. Many medications, such as prednisone, have drug-nutrient interactions that can influence nutrient needs.

• A. Both statements are true
• B. Both statements are false
• C. The first statement is true; the second is false
• D. The first statement is false; the second is true

Correct answer: A

Rationale: Both statements are true. The health history aims to uncover health-related factors that could pose nutritional risks, including medications like prednisone that may have interactions affecting nutrient requirements. Choice B is incorrect as both statements are accurate, emphasizing the significance of health history in assessing nutritional concerns.

2. In preparation for ECT, the nurse knows that it is almost similar to that of:

• A. ECG
• B. General Anesthesia
• C. EEG
• D. MRI

Correct answer: B

Rationale: The correct answer is B: General Anesthesia. In preparation for ECT (Electroconvulsive Therapy), the nurse should be aware that it is almost similar to the process of administering general anesthesia. This similarity is crucial as it involves sedation and muscle relaxation to ensure safety during the procedure. Choice A (ECG) is incorrect because ECT and ECG (Electrocardiogram) serve different purposes and involve distinct procedures. Choice C (EEG) is incorrect as EEG (Electroencephalogram) measures brain activity and is not directly related to ECT. Choice D (MRI) is also incorrect as MRI (Magnetic Resonance Imaging) is a diagnostic imaging procedure that does not involve sedation or muscle relaxation like ECT and general anesthesia.

3. Children with cerebral palsy, Down syndrome, and intellectual disabilities are likely to have abnormal sensory input and muscle tone. A small, underdeveloped tongue is common in many such disorders and results in diminished nutritional status.

• A. Both statements are true
• B. Both statements are false
• C. The first statement is true; the second is false
• D. The first statement is false; the second is true

Correct answer: C

Rationale: The first statement is true, but the second is false. These children often have a large tongue or tongue thrust, which can interfere with feeding and nutrition.

4. A nurse is assessing a client who has malnutrition. Which of the following findings should the nurse expect?

• A. Increased vital capacity
• B. Dry skin
• C. Heat intolerance
• D. Decreased mental status

Correct answer: D

Rationale: Malnutrition can lead to a variety of physical and mental symptoms. One common manifestation of malnutrition is a decreased mental status, which includes confusion, lethargy, and cognitive impairment. Dry skin is a typical finding in malnutrition due to the lack of essential nutrients needed for skin health. Heat intolerance is not a direct consequence of malnutrition. While malnutrition can affect respiratory function, it typically leads to decreased vital capacity rather than increased. Therefore, the correct answer is decreased mental status.

5. 24 hours after the creation of a colostomy, what should Nurse Violy identify as the normal appearance of the stoma?

• A. Pink, moist, and slightly protruding from the abdomen
• B. Gray, moist, and slightly protruding from the abdomen
• C. Pink, dry, and slightly protruding from the abdomen
• D. Red, moist, and slightly protruding from the abdomen

Correct answer: A

Rationale: Following colostomy surgery, a healthy stoma should appear pink, moist, and slightly protruding from the abdomen, which is why option 'A' is the correct answer. A gray stoma (choice 'B') could indicate poor blood supply or necrosis, which is a serious complication. A dry stoma (choice 'C') is also not normal as it should be moist; a dry stoma may suggest dehydration or other complications. While a stoma can appear red (choice 'D'), this is not typically the normal color; it should usually be pink. Therefore, it's important for healthcare professionals to correctly identify the normal and abnormal appearances of a stoma to ensure proper patient care.

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