Nursing Elites

1. What condition has been shown to be associated with esophageal dysphagia?

• A. myasthenia gravis
• B. achalasia
• C. Alzheimer's disease
• D. cerebral palsy

Correct answer: B

Rationale: Achalasia is the correct answer. It is a condition characterized by the esophagus having difficulty moving food toward the stomach, resulting in dysphagia (difficulty swallowing). Myasthenia gravis (Choice A) is a neuromuscular disorder that affects skeletal muscles, not the esophagus. Alzheimer's disease (Choice C) primarily affects cognitive function, not the esophagus. Cerebral palsy (Choice D) is a neurological disorder affecting body movement and muscle coordination, unrelated to esophageal dysphagia.

2. Clients may benefit from slightly higher fat intakes than are normally recommended if they have:

• A. congestive heart failure
• B. cerebrovascular accident
• C. peripheral vascular disease
• D. chronic obstructive pulmonary disease

Correct answer: D

Rationale: In chronic obstructive pulmonary disease (COPD), higher fat intake can be beneficial because it provides more calories with less respiratory burden compared to carbohydrates. Choices A, B, and C are incorrect because congestive heart failure, cerebrovascular accident, and peripheral vascular disease do not specifically benefit from higher fat intakes as in COPD.

3. Bacterial growth and plaque formation are enhanced by a diet with frequent intake of retentive carbohydrates. Gingivitis is an irreversible change in the interdental papillary tissues.

• 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 correct answer is C. The first statement is true; retentive carbohydrates promote bacterial growth and plaque formation. However, the second statement is false; gingivitis is not irreversible and is often reversible with proper care. Gingivitis is the inflammation of the gums due to plaque buildup and poor oral hygiene. With good oral hygiene practices and professional dental care, gingivitis can be reversed. The other choices are incorrect because gingivitis is not irreversible, making statement two false.

4. For an incontinent elderly client who frequently wets his bed and develops redness and skin excoriation at the perianal area, what is the best nursing goal?

• A. Ensure that the bed linen is always dry
• B. Frequently check the bed for wetness and keep it dry
• C. Place a rubber sheet under the client's buttocks
• D. Keep the patient clean and dry

Correct answer: A

Rationale: The best nursing goal for an incontinent elderly client with skin excoriation is to ensure that the bed linen is always dry. This helps in preventing further skin breakdown and promoting skin integrity. Choice B, to frequently check the bed for wetness and keep it dry, may not address the issue of prevention if the linen is not consistently dry. Choice C, placing a rubber sheet under the client's buttocks, focuses more on protecting the mattress rather than addressing the client's skin condition directly. Choice D, keeping the patient clean and dry, is important but does not specifically address the preventive aspect of maintaining dry bed linen.

5. A nurse is instructing a group of clients regarding calcium-rich foods. Which of the following foods should the nurse include in the teaching as the best source of calcium?

• A. 1?2 cup ice cream
• B. 1 ounce Swiss cheese
• C. 1 cup milk
• D. 1 cup cottage cheese

Correct answer: D

Rationale: Cottage cheese is the best source of calcium among the options provided. It is rich in calcium and provides a significant amount per serving. 1 cup of cottage cheese contains more calcium compared to 1?2 cup of ice cream, 1 ounce of Swiss cheese, or 1 cup of milk. Ice cream is not a significant source of calcium and is often high in sugar and fat. Swiss cheese and milk contain calcium, but cottage cheese has a higher calcium content per serving, making it the best choice for meeting calcium needs.

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