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. A patient with renal insufficiency should limit the intake of which of the following nutrients?

• A. Phosphorus
• B. Potassium
• C. Sodium
• D. Calcium

Correct answer: A

Rationale: In patients with renal insufficiency, impaired kidney function can lead to difficulty in excreting phosphorus. High phosphorus levels can result in further complications such as bone and heart problems. Therefore, limiting the intake of phosphorus is crucial. Potassium and sodium restrictions may also be necessary in renal insufficiency, but the primary concern related to nutrients is phosphorus in this scenario. Calcium, while important for bone health, does not typically need to be restricted in renal insufficiency unless there is a specific medical reason to do so.

3. In PEM, which condition is characterized by symptoms such as muscle weakness, hanging skin, delayed tooth eruption, and changes in saliva?

• A. Marasmus
• B. Kwashiorkor
• C. Anemia
• D. Noma

Correct answer: A

Rationale: The correct answer is Marasmus. Marasmus is a severe form of protein-energy malnutrition (PEM) that leads to muscle wasting, hanging skin, delayed growth, and changes in saliva. These symptoms are commonly seen in vulnerable populations such as children, homeless individuals, older adults, and substance abusers. Kwashiorkor, on the other hand, is characterized by edema, a distended belly, and skin lesions. Anemia is a condition characterized by a low red blood cell count, leading to fatigue and weakness. Noma is a severe infection affecting the face, particularly the mouth and jaw area.

4. A nurse is caring for a client who is lactose intolerant. Which of the following clinical manifestations should the nurse assess?

• A. Fever
• B. Blood in stools
• C. Cramping
• D. Steatorrhea

Correct answer: C

Rationale: The correct answer is C: Cramping. Cramping is a common clinical manifestation of lactose intolerance due to the inability to digest lactose properly. Fever (choice A) is not typically associated with lactose intolerance. Blood in stools (choice B) is more indicative of other gastrointestinal issues like inflammatory bowel disease. Steatorrhea (choice D) is the presence of excess fat in the stool and is not a typical symptom of lactose intolerance.

5. What is the best dietary advice for a patient with iron-deficiency anemia?

• A. Increase dairy consumption
• B. Increase vitamin C intake
• C. Reduce red meat consumption
• D. Increase fiber intake

Correct answer: B

Rationale: The best dietary advice for a patient with iron-deficiency anemia is to increase vitamin C intake. Vitamin C enhances the absorption of non-heme iron, which can help improve iron-deficiency anemia. Choices A, C, and D are not the best options for this condition. Increasing dairy consumption (Choice A) may not directly address the iron deficiency. Reducing red meat consumption (Choice C) may limit heme iron intake, which is easily absorbed by the body. Increasing fiber intake (Choice D) is generally beneficial but is not specifically recommended as the top advice for iron-deficiency anemia.

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