Nursing Elites

1. Which of the following questions illustrates the group role of encourager?

• A. What were you saying?
• B. Who wants to respond next?
• C. Where do you go from here?
• D. Why haven’t we heard from you?

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

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. Which animal-derived food contains the most significant level of carbohydrates?

• A. Egg
• B. Beef
• C. Milk
• D. Poultry

Correct answer: C

Rationale: Milk contains the most significant level of carbohydrates among animal-derived foods. Milk and milk products supply significant quantities of carbohydrate in the form of lactose. Eggs, beef, and poultry are not significant sources of carbohydrates compared to milk. In cheese making, lactose is removed as a by-product, reducing the carbohydrate content further.

4. 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.

5. The recommended daily fluid intake of patients maintained using hemodialysis is:

• A. 150 mL plus the volume of urinary output
• B. 500 mL plus the volume of urinary output
• C. 1000 mL plus the volume of urinary output
• D. 1500 mL plus the volume of urinary output

Correct answer: C

Rationale: The correct answer is C: 1000 mL plus the volume of urinary output. Fluid intake is typically restricted in hemodialysis patients to prevent fluid overload. The recommended daily fluid intake for these patients is 1000 mL plus any urinary output. Choice A (150 mL plus the volume of urinary output) is too low and would not provide enough fluid for these patients. Choice B (500 mL plus the volume of urinary output) is also insufficient. Choice D (1500 mL plus the volume of urinary output) is too high and may lead to fluid overload in hemodialysis patients.

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