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. The following are all classes of nutrients except:

• A. protein
• B. fat
• C. carbs
• D. phytochemicals

Correct answer: D

Rationale: Phytochemicals are not considered a class of nutrients. While proteins, fats, and carbohydrates are essential macronutrients providing energy and structural support, phytochemicals are non-nutrient compounds found in plants that offer various health benefits but are not essential for sustaining life like the other three choices. Therefore, the correct answer is D.

3. Each statement is true regarding oral exposure to fermentable carbohydrates, except one. Which is the exception?

• A. Longer exposure leads to an increased risk of demineralization
• B. Longer exposure increases the opportunity for remineralization
• C. The Stephan curve illustrates pH changes within plaque after rinsing with a sugar solution
• D. The critical pH at which enamel decalcification occurs is 5.5 or less

Correct answer: B

Rationale: All the statements above are accurate about oral exposure to fermentable carbohydrates, except for option B. In fact, longer exposure to these carbohydrates decreases the opportunity for remineralization. This is because the process of demineralization, in which minerals are lost from the tooth enamel, is sped up by the presence of fermentable carbohydrates. The Stephan curve (option C) is a graph that demonstrates how the pH of dental plaque changes after a sugar rinse, usually dropping (becoming more acidic), which can lead to enamel decalcification. Option D is also accurate, as a pH of 5.5 or lower is the critical point at which enamel starts to decalcify.

4. A client with nephropathy secondary to diabetes mellitus is receiving dietary teaching from a nurse and plans to make dietary adjustments. Which of the following instructions should the nurse include?

• A. Consume less than 45% of total calories from carbohydrates per day.
• B. Eat no more than 300 mg of cholesterol per day.
• C. Consume less than 0.8 g/kg of body weight of protein per day.
• D. Eat at least 45 g of fiber per day.

Correct answer: D

Rationale: For a client with nephropathy secondary to diabetes mellitus, increasing fiber intake is essential as it can help manage blood sugar levels and improve overall bowel health. Choice A is incorrect because carbohydrates should be controlled but not limited to less than 45% of total calories. Choice B is incorrect as the recommended daily cholesterol intake for individuals with diabetes is less than 200 mg. Choice C is incorrect as protein intake should be individualized based on the client's condition and should not be limited to less than 0.8 g/kg of body weight per day.

5. Patients with this chronic nutrient deficiency may feel tired, weak, and irritable while being unable to pinpoint why. Hypertension, heart attack, stroke, kidney stones, and osteoporosis are associated with the chronic deficiency of which nutrient?

• A. Zinc
• B. Iron
• C. Sodium
• D. Potassium

Correct answer: D

Rationale: The correct answer is D: Potassium. Chronic potassium deficiency can lead to hypertension, heart attack, stroke, kidney stones, and osteoporosis. Patients experiencing this deficiency may feel tired, weak, and irritable without knowing the cause. Choice A (Zinc) is incorrect as zinc deficiency presents with different symptoms. Choice B (Iron) deficiency is associated with anemia symptoms, not the conditions listed. Choice C (Sodium) deficiency typically manifests as muscle cramps, weakness, and confusion, not the conditions described in the question.

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