Nursing Elites

1. A client who underwent surgical placement of a colostomy is being cared for by a nurse. Which of the following statements indicates the client understands the dietary teaching?

• A. "Eating yogurt can help decrease the amount of gas that I have."?
• B. "I should eliminate pasta from my diet so that I don't have as many loose stools."?
• C. "My largest meal of the day should be in the evening."?
• D. "Carbonated beverages can help control odor."?

Correct answer: D

Rationale: The correct answer is D. Carbonated beverages can help control odor in clients with colostomies. This is because carbonated drinks can help decrease odor by reducing the production of odoriferous compounds in the colon. Choices A, B, and C are incorrect. Eating yogurt may help regulate bowel movements but does not specifically address odor control associated with colostomies. Eliminating pasta from the diet to reduce loose stools is not necessary for colostomy care. The timing of the largest meal of the day is not directly related to dietary teaching for colostomy care.

2. Which neuromuscular disease is characterized by abnormal chewing and swallowing patterns, tremors of the mandible, lip, and tongue, frequent drooling, and holding food in the mouth for extended periods?

• A. Developmental disabilities
• B. Parkinson's disease
• C. Epilepsy
• D. Diabetes mellitus

Correct answer: B

Rationale: The correct answer is B, Parkinson's disease. Parkinson's disease is characterized by abnormal chewing and swallowing patterns, tremors of the mandible, lip, and tongue, frequent drooling, and difficulties in oral functions like holding food in the mouth. Developmental disabilities (Choice A) do not specifically cause these symptoms related to neuromuscular function. Epilepsy (Choice C) is a neurological disorder characterized by recurrent seizures and does not typically present with the described symptoms. Diabetes mellitus (Choice D) is a metabolic disorder that affects blood sugar regulation and does not directly cause the neuromuscular symptoms mentioned in the question.

3. A client who is postoperative following a liver transplant and weighs 65 kg. Which of the following actions should the nurse plan to take?

• A. Keep the client NPO for the first week postoperative.
• B. Limit caloric content once the client resumes eating.
• C. Stress the importance of safe food-handling practices.
• D. Decrease foods high in carbohydrates once the client resumes eating.

Correct answer: C

Rationale: After a liver transplant, it is crucial to stress the importance of safe food-handling practices to prevent foodborne illnesses, especially due to the client's altered immune system. Keeping the client NPO for the first week postoperative is not recommended as early nutrition support is essential for recovery. Limiting caloric content once the client resumes eating may not be appropriate as they need adequate nutrition for healing. Decreasing foods high in carbohydrates without a specific indication may lead to inadequate nutrient intake, which is not ideal for the client's recovery.

4. A client with anorexia undergoing radiation therapy is being taught by a nurse. Which instruction should the nurse include in the teaching?

• A. Limit high-calorie supplements to between meals
• B. Avoid overeating during your 'good' days
• C. Eat hot foods instead of cold foods
• D. Consume nutrient-dense foods first

Correct answer: D

Rationale: The correct instruction for a client with anorexia undergoing radiation therapy is to consume nutrient-dense foods first. This ensures that the client receives the necessary calories and nutrients. Option A is incorrect because high-calorie supplements should not be limited but rather incorporated wisely into the diet. Option B is incorrect as overeating is not recommended regardless of the type of day. Option C is incorrect as there is no specific preference for hot foods over cold foods in managing anorexia during radiation therapy.

5. What does oliguria lead to in patients with acute kidney injury?

• A. Hypophosphatemia and overgrowth of bone tissue
• B. An increase in blood potassium levels due to excessive excretion of parathyroid hormone
• C. Sodium retention and elevated levels of potassium
• D. Edema due to increased urine production

Correct answer: C

Rationale: In patients with acute kidney injury, oliguria (reduced urine output) often results in sodium retention and hyperkalemia (elevated levels of potassium). This is due to the kidneys' decreased capacity to excrete these substances. Choice A is incorrect because hypophosphatemia and overgrowth of bone tissue are not direct consequences of oliguria in acute kidney injury. Choice B is incorrect because an increase in blood potassium levels is not caused by excessive excretion of parathyroid hormone but rather by decreased excretion of potassium. Choice D is incorrect because edema is not caused by increased urine production but rather by fluid overload due to decreased urine output.

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