Nursing Elites

1. A nurse at a provider's office is providing teaching to a client who is taking chemotherapy and losing weight. Which of the following should the nurse recommend to increase calorie and protein intake? (Select one that does not apply.)

• A. Top yogurt with fruits.
• B. Add cream to soups.
• C. Use milk instead of water in recipes.
• D. Increase fluids during meals.

Correct answer: D

Rationale: The correct recommendation to increase calorie and protein intake for a client taking chemotherapy and losing weight is to add cream to soups (choice B), as it provides additional calories and proteins. Using milk instead of water in recipes (choice C) can also increase the calorie and protein content. Topping yogurt with fruits (choice A) can be a healthy choice but may not significantly increase calorie and protein intake. Increasing fluids during meals (choice D) may fill up the stomach, potentially reducing the intake of solid foods, which is not ideal when trying to increase calorie and protein consumption.

2. In the following ingredient list, which is the most abundant by weight? Ingredients: enriched flour, sugars, eggs, soy lecithin, artificial colors, natural flavors, milk.

• A. milk
• B. eggs
• C. sugar
• D. enriched flour

Correct answer: D

Rationale: The correct answer is 'enriched flour.' In ingredient lists, items are typically listed by weight in descending order. Therefore, the first ingredient, in this case, 'enriched flour,' is the most abundant by weight. Choice A, 'milk,' is not the most abundant as it appears last in the list. Choice B, 'eggs,' and choice C, 'sugar,' also rank lower in the list compared to 'enriched flour,' making them less abundant by weight.

3. A nurse is caring for a client following a CVA and observes the client experiencing severe dysphagia. The nurse notifies the provider. Which of the following nutritional therapies will likely be prescribed?

• A. NPO until dysphagia subsides
• B. Supplements via nasogastric tube
• C. Initiation of total parenteral nutrition
• D. Soft residue diet

Correct answer: B

Rationale: In the scenario of severe dysphagia following a CVA, the client may have difficulty swallowing and require alternative nutritional support. Providing supplements via a nasogastric tube allows for the delivery of essential nutrients directly into the stomach, bypassing the swallowing difficulties. NPO (nothing by mouth) until dysphagia subsides may be too restrictive for the client's nutritional needs. Initiation of total parenteral nutrition is usually reserved for cases where enteral feeding is not possible or contraindicated. A soft residue diet may not be suitable for a client experiencing severe dysphagia.

4. An advance directive known as a durable power of attorney involves appointing another person called a(n) _____ to act as the decision maker in the event of the patient's incapacitation.

• A. witness
• B. primary caregiver
• C. health care agent
• D. state proxy

Correct answer: C

Rationale: The correct answer is 'health care agent.' A health care agent is appointed through a durable power of attorney to make medical decisions on behalf of a patient who becomes incapacitated. The term 'witness' (choice A) is incorrect because a witness only observes the signing of the directive and does not make decisions. 'Primary caregiver' (choice B) is also incorrect as they may provide care but are not necessarily legally empowered to make decisions. 'State proxy' (choice D) is not commonly used in the context of advance directives or health care decision making, making it an incorrect choice.

5. The stages of grieving identified by Elizabeth Kubler-Ross are:

• A. Numbness, anger, resolution and reorganization
• B. Denial, anger, identification, depression and acceptance
• C. Anger, loneliness, depression and resolution
• D. Denial, anger, bargaining, depression and acceptance

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

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