Nursing Elites

1. Which is most likely to initiate periodontal disease?

• A. Nutrient deficiencies
• B. Nutrient excesses
• C. Nutrient imbalances
• D. Plaque biofilm

Correct answer: D

Rationale: Plaque biofilm is the primary initiator of periodontal disease, as it harbors bacteria that can lead to inflammation and destruction of the periodontal tissues.

2. The nurse is completing a nutritional assessment on a client. Which statement made by the client is most concerning to the nurse?

• A. "I notice when I take a vitamin E supplement, I bruise more easily."
• B. "I work nights and rarely go outside during the day."
• C. "I take warfarin, so I need to limit the amount of green leafy vegetables I eat."
• D. "My vitamin supplement has the recommended daily allowance of vitamin A."

Correct answer: A

Rationale: The correct answer is A. Excessive intake of vitamin E can increase the risk of bleeding as it acts as a blood thinner. Bruising easily may indicate too much vitamin E. Choice B is not as concerning as it describes a lifestyle that may lead to vitamin D deficiency due to lack of sunlight exposure. Choice C shows awareness of the interaction between warfarin and vitamin K, which is expected. Choice D indicates knowledge of the vitamin A content in the supplement, which is not a cause for concern.

3. Symptoms of irritable bowel syndrome are most likely associated with disturbed defecation, bloating, and _____.

• A. rectal bleeding
• B. abdominal pain
• C. rectal fissures
• D. esophageal paralysis

Correct answer: B

Rationale: Abdominal pain is a common symptom of irritable bowel syndrome (IBS), along with bloating and changes in bowel habits. Rectal bleeding (choice A) is more commonly associated with conditions like inflammatory bowel disease or colorectal cancer. Rectal fissures (choice C) may cause rectal bleeding but are not typically considered a core symptom of IBS. Esophageal paralysis (choice D) is unrelated to the symptoms of IBS, which primarily affect the lower gastrointestinal tract.

4. Mario listens to Richard’s bilateral sounds and finds that congestion is in the upper lobes of the lungs. The appropriate position to drain the anterior and posterior apical segments of the lungs when Mario does percussion would be:

• A. Client lying on his back then flat on his abdomen on Trendelenburg position
• B. Client seated upright in bed or on a chair then leaning forward in sitting position then flat on his back and on his
• C. Client lying flat on his back and then flat on his abdomen
• D. Client lying on his right then left side on Trendelenburg position

Correct answer: A

Rationale: Proper patient positioning is essential for maximizing lung expansion and promoting the drainage of secretions. Postural drainage techniques rely on gravity to help clear different lung segments, which is critical in preventing complications such as atelectasis or pneumonia in immobilized patients.

5. Where is Vitamin K synthesized?

• A. by bacteria in the GI tract
• B. by the body by sunlight
• C. deficiency is called beriberi
• D. found in vegetable oils

Correct answer: A

Rationale: Vitamin K is synthesized by bacteria in the gastrointestinal tract. Choice B is incorrect as the synthesis of Vitamin D, not K, can be induced by sunlight exposure. Choice C is incorrect as beriberi is a condition caused by thiamine (Vitamin B1) deficiency, not Vitamin K. Choice D is incorrect as Vitamin E is commonly found in vegetable oils, not Vitamin K.

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