Nursing Elites

1. What nutrition-related side effect is most likely to occur after head and neck surgery for cancer treatment?

• A. Aspiration
• B. Acid reflux
• C. Dumping syndrome
• D. Diarrhea

Correct answer: A

Rationale: The most likely nutrition-related side effect after head and neck surgery for cancer treatment is aspiration. This is due to changes in swallowing mechanics, which can cause food or liquids to be inhaled into the lungs. While acid reflux, dumping syndrome, and diarrhea are potential side effects related to nutrition, they are not as directly connected to head and neck surgery. Acid reflux is more often related to issues with the lower esophageal sphincter, dumping syndrome is typically a complication of gastric surgery, and diarrhea can have various causes, including certain medications or gastrointestinal illnesses.

2. What symptoms would most likely be associated with a transient ischemic attack?

• A. confusion and difficulty speaking
• B. headache and blurred vision
• C. chest pain and pressure
• D. claudication and peripheral edema

Correct answer: A

Rationale: The correct answer is A: confusion and difficulty speaking. These symptoms are commonly associated with a transient ischemic attack (TIA), which is a temporary blockage of blood flow to the brain. Choice B, headache and blurred vision, are more indicative of other conditions such as migraines or eye problems. Choice C, chest pain and pressure, are more characteristic of cardiac issues like a heart attack. Choice D, claudication and peripheral edema, are typical of peripheral arterial disease and not typically seen in TIAs.

3. Which of the following interventions should be considered the highest priority when caring for June, who has hemiparesis secondary to a stroke?

• A. Position June in an upright lateral position
• B. Perform range of motion exercises
• C. Apply antiembolic stockings
• D. Use hand rolls or pillows for support

Correct answer: C

Rationale: The correct answer is C, 'Apply antiembolic stockings'. In the case of a patient who has experienced a stroke and is suffering from hemiparesis, the highest priority intervention is to prevent further complications such as deep vein thrombosis (DVT), which can be life-threatening. Antiembolic stockings are used to increase venous blood flow velocity and reduce the risk of DVT. Choice 'A', positioning June in an upright lateral position, while important for overall care, is not the highest priority. Choice 'B', performing range of motion exercises, is an important part of recovery but not the immediate priority. Choice 'D', using hand rolls or pillows for support, is also a valuable intervention but does not address the most pressing risk of further complications.

4. The nurse notes that the fall might also cause a possible head injury. The patient will be observed for signs of increased intracranial pressure which include:

• A. Narrowing of the pulse pressure
• B. Vomiting
• C. Periorbital edema
• D. A positive Kernig's sign

Correct answer: C

Rationale: Periorbital edema is a sign of increased intracranial pressure. It is caused by fluid accumulation around the eyes due to compromised drainage. Narrowing of the pulse pressure is more indicative of shock than increased intracranial pressure. While vomiting can be a sign of increased intracranial pressure, it is not as specific as periorbital edema. A positive Kernig's sign is associated with meningitis, not increased intracranial pressure.

5. Which nutrient is most important for pregnant women to prevent neural tube defects?

• A. Iron
• B. Folate
• C. Calcium
• D. Vitamin D

Correct answer: B

Rationale: Folate (or folic acid) is crucial for the prevention of neural tube defects during pregnancy.

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