Nursing Elites

1. A community health nurse is conducting a class on what to expect during pregnancy. What instruction should the nurse include on weight gain?

• A. Failure to obtain the required weight gain during pregnancy will increase the risk of preterm birth.
• B. An obese client should not gain as much weight as a client with a normal body mass index.
• C. A client with a normal body mass index should plan on gaining 50 pounds.
• D. Clients do not need to eat for two when they are pregnant.

Correct answer: A

Rationale: Adequate weight gain during pregnancy is essential as failure to obtain the required weight gain can increase the risk of preterm birth. Choice B is incorrect because it is important for obese clients to gain an appropriate amount of weight during pregnancy, not the same as those with a normal body mass index. Choice C is incorrect as gaining 50 pounds for a client with a normal body mass index is excessive. Choice D is incorrect as the common saying 'eating for two' during pregnancy is a misconception; pregnant individuals do not need to double their caloric intake.

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. Patients with this chronic nutrient deficiency may feel tired, weak, and irritable while being unable to pinpoint why. Hypertension, heart attack, stroke, kidney stones, and osteoporosis are associated with the chronic deficiency of which nutrient?

• A. Zinc
• B. Iron
• C. Sodium
• D. Potassium

Correct answer: D

Rationale: The correct answer is D: Potassium. Chronic potassium deficiency can lead to hypertension, heart attack, stroke, kidney stones, and osteoporosis. Patients experiencing this deficiency may feel tired, weak, and irritable without knowing the cause. Choice A (Zinc) is incorrect as zinc deficiency presents with different symptoms. Choice B (Iron) deficiency is associated with anemia symptoms, not the conditions listed. Choice C (Sodium) deficiency typically manifests as muscle cramps, weakness, and confusion, not the conditions described in the question.

4. A patient who is recovering from surgery should increase their intake of which nutrient to promote healing?

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

Correct answer: C

Rationale: Protein is crucial for tissue repair and recovery after surgery. Proteins provide the building blocks necessary for tissue healing and regeneration. Fats are important for various bodily functions but are not as directly involved in tissue repair as proteins. Carbohydrates provide energy but do not play a primary role in tissue healing. Fiber is essential for digestive health but is not a nutrient that directly promotes tissue repair.

5. Medication for treating high blood cholesterol levels should not be used for most people unless:

• A. The patient has at least three major risk factors for coronary heart disease
• B. The patient has been experiencing symptoms of coronary heart disease for at least three months
• C. The patient's medical insurance covers prescription drugs
• D. Treatment with Therapeutic Lifestyle Changes (TLC) alone is unsuccessful after three months

Correct answer: D

Rationale: The correct answer is choice D because medication for high cholesterol is typically not considered unless Therapeutic Lifestyle Changes (TLC), which include diet and exercise, have not proven effective after a three-month period. This approach ensures that lifestyle modifications are given a fair chance to lower cholesterol levels before resorting to medication. Choice A is incorrect because the number of risk factors for coronary heart disease does not dictate when to begin medication; it is about the effectiveness of lifestyle changes. Choice B is incorrect as the duration of coronary heart disease symptoms does not determine when to start medication; the focus is on the response to TLC. Choice C is incorrect because the coverage of prescription drugs by the patient's insurance does not influence the medical decision to use medication for high cholesterol; it is based on medical necessity and effectiveness of prior interventions.

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