Nursing Elites

1. 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.

2. Which is NOT a characteristic or function of lipids?

• A. Involved in energy metabolism and storage
• B. Provide insulation and protection
• C. Act as hormones that regulate the body
• D. Are hydrophilic

Correct answer: D

Rationale: Lipids are known for several functions including involvement in energy metabolism and storage (Choice A), providing insulation and protection (Choice B), and acting as hormones that regulate the body (Choice C). However, lipids are not hydrophilic (water-attracting), contrary to choice D. They are actually hydrophobic, meaning they repel water and do not mix well with it. This is a key property that differentiates them from many other biological molecules.

3. What symptom would most likely be associated with late dumping syndrome?

• A. abdominal cramps
• B. nausea
• C. diarrhea
• D. confusion

Correct answer: D

Rationale: Confusion is the most likely symptom associated with late dumping syndrome. Late dumping syndrome occurs when blood sugar levels drop rapidly after eating due to rapid gastric emptying. While abdominal cramps, nausea, and diarrhea can occur with dumping syndrome, confusion is specifically linked to late dumping syndrome due to hypoglycemia.

4. 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.

5. What factor has been shown to contribute to poor nutritional health among adolescents?

• A. Most teens choose fruit juice and milk over soda
• B. Many teens consume energy drinks on a regular basis
• C. Teens have busy schedules and rarely drink fluids throughout the day
• D. Teens are more likely to consume low-fat milk

Correct answer: B

Rationale: The correct answer is B because many teens regularly consume energy drinks, which can contribute to poor nutritional health due to their high sugar and caffeine content, leading to unhealthy dietary patterns. Choice A is incorrect because choosing fruit juice and milk over soda would generally be considered a healthier choice. Choice C is incorrect as busy schedules leading to inadequate fluid intake might impact hydration but not necessarily poor nutritional health. Choice D is also incorrect as consuming low-fat milk is not typically a significant factor contributing to poor nutritional health among adolescents.

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