Nursing Elites

1. A common comorbidity in patients with Chronic Kidney Disease (CKD) is:

• A. Liver disease
• B. Malnutrition
• C. Acute renal failure
• D. Difficulty breathing

Correct answer: B

Rationale: Malnutrition is a common comorbidity in patients with Chronic Kidney Disease (CKD). This is mainly due to factors such as dietary restrictions, poor appetite, and the body's increased nutritional needs as it struggles to deal with the disease. Liver disease (Choice A) is not typically associated directly with CKD, although both conditions may coexist in some patients. Acute renal failure (Choice C) is not a comorbidity but a severe and potentially lethal progression of CKD. Difficulty breathing (Choice D) is not a comorbidity but can be a symptom of severe kidney disease or other underlying conditions. However, malnutrition is more commonly observed in CKD patients compared to difficulty breathing.

2. An adolescent client has bloodshot eyes, a voracious appetite, and dry mouth. Which drug abuse would the nurse most likely suspect?

• A. Marijuana
• B. Amphetamines
• C. Barbiturates
• D. Anxiolytics

Correct answer: A

Rationale: The symptoms described, including bloodshot eyes, a voracious appetite, and dry mouth, are consistent with marijuana use. Bloodshot eyes are a common side effect of marijuana due to its effect on blood vessels in the eyes. Marijuana also often causes an increase in appetite (known as 'the munchies') and can result in dry mouth. Amphetamines typically cause symptoms like increased alertness, energy, and decreased appetite. Barbiturates and anxiolytics would not typically cause bloodshot eyes, a voracious appetite, and dry mouth as described in the scenario. Therefore, the most likely drug abuse the nurse would suspect in this case is marijuana.

3. A nurse is caring for a client who has cancer and is receiving total parenteral nutrition (TPN). Which of the following lab values indicates the treatment is effective?

• A. Hct 43%
• B. WBC 8,000/uL
• C. Albumin 4.2 g/dL
• D. Calcium 9.4 mg/dL

Correct answer: C

Rationale: The correct answer is Albumin 4.2 g/dL. Albumin is a protein produced by the liver and is a key indicator of nutritional status. In a client receiving total parenteral nutrition (TPN), an increase in albumin level indicates that the treatment is effective in providing adequate nutrition support. Hct (hematocrit), WBC (white blood cell count), and calcium levels are not direct indicators of the effectiveness of TPN in this context.

4. What would you do to increase the amount of iron absorbed from a meal?

• A. Drink plenty of coffee before each meal
• B. Avoid eating foods rich in vitamin C with the meal
• C. Eat a calcium-rich food with the meal
• D. Consume orange juice as a beverage with a meal

Correct answer: D

Rationale: The correct answer is D: 'Consume orange juice as a beverage with a meal'. This is because Vitamin C significantly enhances the absorption of non-heme iron, a form of iron found in plant-based foods. Therefore, consuming orange juice, which is rich in vitamin C, with a meal can effectively increase iron absorption. On the contrary, choices A, B, and C are incorrect. Coffee (Choice A) contains polyphenols that can inhibit iron absorption. Avoiding vitamin C-rich foods (Choice B) would decrease iron absorption, not increase it. While calcium (Choice C) is essential for many bodily processes, it can actually inhibit iron absorption when consumed together.

5. 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.

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