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. In a patient with osteoporosis, which mineral is essential to prevent further bone loss?

• A. Iron
• B. Phosphorus
• C. Magnesium
• D. Calcium

Correct answer: D

Rationale: Calcium is crucial in preventing bone loss in patients with osteoporosis.

3. A nurse is instructing the mother of a toddler who has iron-deficiency anemia to increase iron in the child's diet in addition to the prescribed iron supplement. Which of the following foods should the nurse recommend?

• A. Skim milk
• B. Bananas
• C. Tuna fish
• D. Cucumbers

Correct answer: C

Rationale: Tuna fish is a good source of iron and would be beneficial for a toddler with iron-deficiency anemia. Skim milk, bananas, and cucumbers are not significant sources of iron and would not help in increasing the iron levels in the child's diet. Skim milk, in particular, can inhibit iron absorption due to its calcium content, which is important for the nurse to educate the mother about.

4. Which of the following is the least likely reason that osteoporosis is more prevalent in women?

• A. women have smaller bodies
• B. women have lower bone mass
• C. women consume less calcium
• D. bone loss begins later in women

Correct answer: D

Rationale: The correct answer is D. Contrary to the statement, bone loss begins earlier in women, particularly after menopause, due to the decrease in estrogen levels. This drop in estrogen accelerates bone loss, contributing to the higher prevalence of osteoporosis in women. Choices A, B, and C are more likely reasons for the increased prevalence of osteoporosis in women. Women generally have smaller bodies, lower bone mass compared to men, and may consume less calcium, all of which are significant factors contributing to the higher incidence of osteoporosis in women.

5. Which of the following are the primary bacteria involved in the initiation of dental caries?

• A. Streptococcus mutans and Lactobacillus species
• B. Salmonella and Listeria species
• C. Streptococcus, Lactobacillus, and Salmonella species
• D. Listeria, Botulinum species, and Escherichia coli

Correct answer: A

Rationale: The correct answer is A: Streptococcus mutans and Lactobacillus species. These bacteria are primarily responsible for initiating dental caries by fermenting carbohydrates and producing acids that demineralize enamel. Choice B, Salmonella and Listeria species, are not the primary bacteria involved in dental caries. Choice C includes Salmonella which is not a primary culprit in dental caries. Choice D lists Listeria, Botulinum species, and Escherichia coli, none of which are the primary bacteria associated with initiating dental caries.

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