Nursing Elites

1. A client receiving total parenteral nutrition (TPN) suddenly develops tremors, dizziness, and diaphoresis. The client said, 'I feel weak and the bag was empty.' Which is the most likely complication the client is currently experiencing?

• A. Fluid volume overload
• B. Sepsis
• C. Hyperglycemia
• D. Hypoglycemia

Correct answer: D

Rationale: The client experiencing tremors, dizziness, diaphoresis, weakness, and stating that the TPN bag is empty is likely experiencing hypoglycemia. Hypoglycemia can occur when the TPN infusion suddenly stops, leading to a rapid drop in blood sugar levels. Symptoms of hypoglycemia include tremors, dizziness, diaphoresis, and weakness. Choices A, B, and C are incorrect as the symptoms presented are more consistent with hypoglycemia rather than fluid volume overload, sepsis, or hyperglycemia.

2. The OR team performs distinct roles for one surgical procedure to be accomplished within a prescribed time frame and deliver a standard patient outcome. While the surgeon performs the surgical procedure, who monitors the status of the client like urine output, blood loss?

• A. Scrub Nurse
• B. Surgeon
• C. Anaesthesiologist
• D. Circulating Nurse

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

3. After reviewing the health and dental histories, the dental hygienist has adequate information to begin dietary counseling with the patient. Providing a standardized, low-carbohydrate menu is sufficient for most patients with a high caries rate.

• 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: B

Rationale: Both statements are false. Dietary counseling should be personalized, and a standardized low-carbohydrate menu is not sufficient for all patients.

4. Why are blood glucose levels high in type 1 diabetes?

• A. The urinary excretion of glucose is impaired
• B. The lean body mass is metabolized to produce glucose via gluconeogenesis
• C. The absorption of glucose from the gastrointestinal tract is more efficient
• D. There is insufficient insulin to facilitate the transport of glucose into the cells

Correct answer: D

Rationale: In type 1 diabetes, the body's immune system destroys the beta cells in the pancreas that produce insulin. This leads to an insufficient amount of insulin, which is required to facilitate the transport of glucose into the cells. Consequently, blood glucose levels remain high. The other options are incorrect. Option A is incorrect because urinary excretion of glucose does not directly contribute to blood glucose levels. Option B is incorrect because, while gluconeogenesis does produce glucose, it is not the cause of high glucose levels in type 1 diabetes. Option C is incorrect because absorption efficiency of glucose from the gastrointestinal tract does not affect the amount of insulin available to transport glucose into cells.

5. A client is receiving education from a nurse regarding the dietary changes needed for weight loss. Which of the following actions should the nurse perform first?

• A. Educate the client about daily caloric requirements.
• B. Determine the client’s daily caloric intake.
• C. Provide the client with meal planning information.
• D. Show the client how to identify the fat content of packaged foods.

Correct answer: B

Rationale: The correct answer is to determine the client’s daily caloric intake first. This step is crucial in understanding the client's current dietary habits and establishing a baseline for creating an effective weight loss plan. Educating the client about daily caloric requirements (Choice A) can only be done effectively after knowing the client's current intake. Providing meal planning information (Choice C) and teaching the client how to identify fat content in foods (Choice D) come after determining the baseline caloric intake to tailor the plan accordingly.

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