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. For a patient on a ketogenic diet, which macronutrient is primarily increased?

• A. Carbohydrates
• B. Protein
• C. Fats
• D. Fiber

Correct answer: C

Rationale: The correct answer is C: Fats. A ketogenic diet is characterized by high fat intake, moderate protein intake, and very low carbohydrate intake. This diet aims to shift the body's metabolism to use fat as the primary source of energy instead of carbohydrates. Increasing fat intake while reducing carbohydrates is essential for achieving and maintaining a state of ketosis. Therefore, choices A, B, and D are incorrect as they do not align with the macronutrient adjustments required for a ketogenic diet.

3. A nurse is providing teaching to a group of older adults about oil-rich foods. Which of the following foods should be included as the equivalent of 6 tsp of oil?

• A. 1 tbsp soft margarine
• B. 1?2 oz of nuts
• C. 2 tbsp peanut butter
• D. 1 oz sunflower seeds

Correct answer: C

Rationale: The correct answer is 2 tbsp peanut butter. 6 teaspoons of oil are equivalent to 2 tablespoons of oil. Peanut butter is a good source of oil and healthy fats. Choice A, 1 tbsp soft margarine, is incorrect because 1 tablespoon is not equivalent to 6 teaspoons. Choice B, 1?2 oz of nuts, is incorrect as nuts are not equivalent to oil-rich foods in this context. Choice D, 1 oz sunflower seeds, is incorrect because 1 ounce of sunflower seeds is not equivalent to 6 teaspoons of oil.

4. A nurse is providing teaching about food allergies to the parents of a toddler. Which of the following foods should the nurse identify as highest risk for allergies in toddlers?

• A. Eggs
• B. Milk
• C. Bananas
• D. Citrus fruits

Correct answer: A

Rationale: The correct answer is A: Eggs. Eggs are one of the most common food allergens in toddlers and should be introduced carefully. Milk (choice B) is also a common allergen but is typically introduced earlier in a child's diet. Bananas (choice C) and citrus fruits (choice D) are less likely to cause allergic reactions compared to eggs.

5. A nurse is providing anticipatory guidance to a client who has Phenylketonuria (PKU) and is planning a pregnancy. Which of the following information should the nurse include in the discussion?

• A. Diet sodas should not be consumed more than two or three times a week.
• B. Serum bilirubin should be monitored once or twice a month during pregnancy.
• C. Breastfeeding will not prevent your baby from developing PKU.
• D. A low-protein diet should be followed for three months before conception.

Correct answer: D

Rationale: A low-protein diet should be followed for three months before conception in individuals with PKU who are planning a pregnancy. This diet helps manage PKU by reducing phenylalanine levels, which is crucial for maternal and fetal health. Choices A, B, and C are incorrect. Choice A is not directly related to managing PKU, choice B focuses on a different aspect of care during pregnancy, and choice C is inaccurate as breastfeeding will not prevent a baby from developing PKU.

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