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 working with a patient who recently had a stroke. The patient frequently chokes and coughs when eating and is having difficulty feeding herself. What is the best way to ensure adequate nutrition?

• A. to have an aide feed her at each meal
• B. to ask a family member to assist during meals
• C. to provide tube feedings for the patient
• D. to initiate TPN for the patient

Correct answer: C

Rationale: The best way to ensure adequate nutrition for a stroke patient who frequently chokes and coughs when eating and has difficulty feeding herself is to provide tube feedings. Tube feedings are a safe and effective method to deliver nutrition directly to the stomach or intestines, bypassing the swallowing mechanism, reducing the risk of aspiration. Having an aide feed her each meal (choice A) may not address the underlying issue of swallowing difficulty and aspiration risk. Asking a family member to be present at each meal (choice B) does not provide a definitive solution to the patient's nutritional needs. Placing the patient on total parenteral nutrition (TPN) (choice D) is a more invasive and typically reserved for patients who cannot tolerate enteral feedings or have non-functional gastrointestinal tracts.

3. Cariogenic foods and beverages, which are fermentable carbohydrates that can be metabolized by oral bacteria, reduce salivary pH to what critical level?

• A. 5
• B. 5.5
• C. 6
• D. 6.5

Correct answer: B

Rationale: Cariogenic foods and beverages lower the pH level in the mouth to below 5.5. This is a critical threshold, as it is the point at which enamel begins to demineralize, increasing the risk of dental caries. Therefore, options 'A', 'C', and 'D' are incorrect. Although a pH level of 5, as suggested by option 'A', would indeed lead to demineralization, it's not the threshold value. The pH levels suggested by options 'C' and 'D' (6 and 6.5, respectively) are higher than the critical value of 5.5, which means they would not initiate enamel demineralization and the subsequent risk of dental caries.

4. What is the priority nursing goal for an adolescent with anorexia nervosa?

• A. Encourage effective coping skills
• B. Restore normal eating habits
• C. Stop weight loss or restore weight
• D. Promote realistic self-image

Correct answer: C

Rationale: The priority nursing goal for an adolescent with anorexia nervosa is to stop weight loss or restore weight. This is crucial in addressing the immediate health risks associated with anorexia nervosa, such as malnutrition, organ damage, and potential life-threatening complications. While encouraging effective coping skills, restoring normal eating habits, and promoting a realistic self-image are important aspects of treatment, stopping weight loss or restoring weight takes precedence due to the severe physical consequences of anorexia nervosa.

5. As the head nurse in the OR, how can you improve the effectiveness of clinical alarm systems?

• A. Limit suppliers to a few so that quality is maintained
• B. Implement a regular inventory of supplies and equipment
• C. Adherence to manufacturer’s recommendation
• D. Implement a regular maintenance and testing of alarm systems

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

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