Nursing Elites

1. A client receiving total parenteral nutrition (TPN is awaiting the next container. What fluid should the nurse infuse in the interim?

• A. Dextrose 5% in water
• B. 0.9% sodium chloride
• C. Dextrose 10% in water
• D. Lactated Ringer's solution

Correct answer: B

Rationale: The correct answer is 0.9% sodium chloride. When a client receiving TPN is awaiting the next container, infusing 0.9% sodium chloride is the appropriate choice to maintain fluid and electrolyte balance. Dextrose solutions are not recommended as they do not provide sufficient nutrition. Lactated Ringer's solution contains electrolytes but lacks essential nutrients found in TPN, making it an inadequate choice during the delay in TPN delivery.

2. What stimulates bile secretion from the liver to the small intestine?

• A. Pepsin
• B. Salivary Amylase
• C. CCK
• D. Secretin

Correct answer: C

Rationale: Cholecystokinin (CCK) is the hormone that stimulates the release of bile from the gallbladder into the small intestine, aiding in fat digestion. Pepsin is an enzyme in the stomach that breaks down proteins into smaller peptides, not involved in bile secretion. Salivary Amylase is an enzyme in saliva that initiates starch digestion in the mouth, not related to bile secretion. Secretin is a hormone that regulates the release of gastric juice in the stomach and triggers the pancreas to neutralize stomach acid in the small intestine, but it does not stimulate bile secretion.

3. What is the procedure called when direct observations are used to generate an estimate of a client's current food intake?

• A. Food diary
• B. 24-hour recall
• C. Kilocalorie count
• D. Nutrient surveillance record

Correct answer: C

Rationale: A kilocalorie count is the correct answer as it involves directly observing a client's food intake, which is often used in hospitals to accurately assess nutritional intake and ensure it meets dietary requirements. A food diary (Choice A) is typically self-reported by the client and not directly observed. A 24-hour recall (Choice B) is also usually self-reported and relies on a client's memory of the past 24 hours, which can be unreliable. A nutrient surveillance record (Choice D) is a broader term for tracking nutrient intake in a population and is not specific to the direct observation of an individual's food intake.

4. Age group categories within older adults are classified as 'young old,' 'old,' and 'oldest old,' the latter of which comprises adults aged _____.

• A. 70-80 years
• B. 75-84 years
• C. 80-90 years
• D. 85 years or older

Correct answer: D

Rationale: The 'oldest old' category includes adults aged 85 years or older. This age group faces unique health challenges and requires specialized care. Choices A, B, and C are incorrect as they do not fall within the age range specified for the 'oldest old' category.

5. Which type of bath would you recommend for a patient experiencing pruritus?

• A. Saline
• B. Colloidal (oatmeal)
• C. Water
• D. Sodium bicarbonate

Correct answer: B

Rationale: The best choice for a pruritus (itching) patient is a colloidal (oatmeal) bath, as it is known for its soothing effect on itchy, irritated skin. Saline, water, and sodium bicarbonate baths may not provide the same level of relief for pruritus. The nursing care should involve comprehensive assessments and appropriate interventions to optimize patient outcomes. In this case, a colloidal bath is the most suitable intervention for a patient experiencing pruritus.

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