Nursing Elites

1. Which theory reflects the view that illness is caused by an imbalance or disharmony in the forces of nature?

• A. Germ theory
• B. Naturalistic theory
• C. Magicoreligious theory
• D. Biomedical or scientific theory

Correct answer: B

Rationale: The naturalistic theory posits that illness results from an imbalance or disharmony in the forces of nature. According to this theory, maintaining a natural balance or harmony is essential to prevent illness. Conversely, germ theory and biomedical or scientific theory attribute illness to microorganisms, while magicoreligious theory attributes illness to supernatural forces such as deities or spirits. Therefore, the most appropriate theory reflecting the belief that illness arises from a disruption in natural forces is the naturalistic theory.

2. When providing mouth care to a patient in a coma, what should you do to provide good and safe mouth care?

• A. keep the head of the bed up to prevent aspiration
• B. brush the teeth and rinse the mouth with a cup of water
• C. use a special foam swab to brush only the tongue
• D. use a special foam swab to brush the tongue and teeth

Correct answer: D

Rationale: When providing mouth care to a patient in a coma, it is crucial to use a special foam swab to brush the tongue and teeth. This method helps maintain good oral hygiene for comatose patients. Special foam swabs are designed to effectively clean all areas of the mouth, including the cheeks and tongue, ensuring thorough care. Using water for mouth care in comatose patients can lead to aspiration, so it is important to avoid this practice. Keeping the head of the bed up alone does not prevent aspiration during mouth care for comatose patients, making choice A incorrect. Merely brushing the tongue (choice C) or using a foam swab only on the tongue (choice B) may not provide the comprehensive mouth care necessary for patients in a coma.

3. A new staff nurse completes orientation to the psychiatric unit. This nurse will expect to ask an advanced practice nurse to perform which action for patients?

• A. Perform mental health assessment interviews
• B. Establish therapeutic relationships
• C. Prescribe psychotropic medications
• D. Individualize nursing care plans

Correct answer: C

Rationale: Prescriptive privileges are granted to Master's-prepared nurse practitioners who have taken special courses on prescribing medications. The nurse prepared at the basic level performs mental health assessments, establishes relationships, and provides individualized care planning. In this scenario, the new staff nurse would ask the advanced practice nurse to prescribe psychotropic medications, as this is within their scope of practice and expertise. Establishing therapeutic relationships, performing mental health assessments, and individualizing care plans are typically responsibilities of staff nurses at the basic level, not advanced practice nurses.

4. The nurse is assessing an 80-year-old male patient. Which assessment finding would be considered normal?

• A. Decrease in body weight from his younger years
• B. Decrease in deposits of fat in the cheeks and forearms
• C. Presence of kyphosis and flexion in bilateral knees and hips
• D. Change in overall body proportion, including a longer trunk and shorter extremities

Correct answer: C

Rationale: In an 80-year-old male patient, the presence of kyphosis (rounded upper back) and flexion in bilateral knees and hips are considered normal age-related changes. These postural changes are commonly seen in older adults due to structural changes in the spine and joints. Option A is incorrect as aging individuals typically experience a decrease in body weight, not an increase. Option B is also incorrect as there is usually a decrease in subcutaneous fat from the face and periphery, rather than an increase in fat deposits in specific areas. Option D is incorrect because the change in overall body proportion with aging usually involves a shorter trunk and relatively longer extremities, not the other way around. This is because long bones do not shorten with age, leading to this characteristic change in body proportions.

5. What term is used to refer to generalized wasting of body tissues and malnutrition?

• A. Entropion
• B. Confabulation
• C. Induration
• D. Cachexia

Correct answer: D

Rationale: Cachexia is the correct term used to describe the generalized wasting of body tissues, ill health, and malnutrition associated with some chronic diseases. It involves a loss of fat tissue to protect the bones and joints. Clients with cachexia are at risk of pressure ulcers and other complications due to malnutrition and poor health. Entropion refers to an eyelid condition, confabulation is a memory disturbance, and induration is the abnormal hardening of a part of the body.

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