Nursing Elites

1. Tony is to be discharged in the afternoon of the same day after tonsillectomy and adenoidectomy. You, as the RN, will make sure that the family knows to:

• A. offer pureed foods
• B. offer soft foods for a week to minimize discomfort while swallowing
• C. supplement his diet with Vitamin C-rich foods to enhance healing
• D. offer clear liquids for 3 days to prevent irritation

Correct answer: B

Rationale: After tonsillectomy and adenoidectomy, it is crucial to provide soft foods for a week to minimize discomfort while swallowing. This helps prevent irritation to the surgical site and allows for easier healing. Offering pureed foods (Choice A) may not be necessary as soft foods are usually sufficient. While Vitamin C is beneficial for healing, it is not necessary to supplement it immediately after surgery with Vitamin C-rich juices (Choice C). Clear liquids are typically recommended before surgery and not after, as the focus shifts to soft foods to aid in recovery, making Choice D incorrect.

2. Water loss can occur from each, except one. Which is the exception?

• A. Respiratory inflammation
• B. Strenuous exercise
• C. Diarrhea
• D. Perspiration

Correct answer: D

Rationale: The correct answer is D, Perspiration. Water loss can occur through respiration inflammation, strenuous exercise, and diarrhea. Perspiration, also known as sweating, is a mechanism by which the body regulates temperature and eliminates some waste products, but it is not a cause of water loss. The body loses water through sweating, but this loss is mainly for cooling purposes, and it is not a primary mechanism for water loss like respiration, exercise, or diarrhea.

3. Why might patients with periodontal disease require increased protein intake?

• A. Both the statement and the reason are correct and related
• B. Both the statement and the reason are correct but are not related
• C. The statement is correct, but the reason is not correct
• D. The statement is not correct, but the reason is correct

Correct answer: A

Rationale: Patients with periodontal disease may require increased protein intake due to the physiological response to inflammation and infection, which can negatively impact protein synthesis. Protein is essential for wound healing and tissue repair, and an infection can increase the body's protein requirements. Therefore, ensuring an adequate protein intake is particularly important for these patients. Choice A is correct because the statement and reason are both accurate and directly related to each other, supporting the increased protein needs in patients with periodontal disease. Choices B, C, and D are incorrect as they do not accurately assess the relationship between the statement and the reason provided in the question.

4. A patient is being cared for by a nurse who has stomatitis following radiation treatment. Which of the following is an appropriate intervention for the nurse to take?

• A. Serve foods without sauces or gravies
• B. Offer mouth rinses with normal saline and water
• C. Serve foods while still at a hot temperature
• D. Instruct the client to drink liquids without a straw

Correct answer: B

Rationale: Offering mouth rinses with normal saline and water is an appropriate intervention for a nurse caring for a patient with stomatitis following radiation treatment. This intervention can help soothe and clean the mouth, promoting comfort and oral hygiene. Choice A is incorrect because serving foods without sauces or gravies does not directly address the client's stomatitis. Choice C is incorrect because serving hot foods can exacerbate discomfort in the client's mouth. Choice D is incorrect because using a straw can help in preventing further irritation in the client's mouth.

5. Which client is most likely to need regular injections of vitamin B12?

• A. The client with malabsorption syndrome.
• B. The client following a vegan eating pattern.
• C. The client whose stomach does not produce intrinsic factors.
• D. The client with alcoholism.

Correct answer: C

Rationale: The correct answer is C. The client whose stomach does not produce intrinsic factors is most likely to need regular injections of vitamin B12. Intrinsic factor is essential for the absorption of vitamin B12. Without intrinsic factor, the client cannot absorb vitamin B12 from food, necessitating the need for regular injections. Choices A, B, and D do not directly impact the production of intrinsic factors in the stomach, so they are less likely to result in the need for vitamin B12 injections.

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