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 nursing diagnosis would be most appropriate for a patient with heart failure?

• A. risk for infection
• B. fluid volume excess
• C. impaired body temperature
• D. ineffective airway clearance

Correct answer: B

Rationale: The most appropriate nursing diagnosis for a patient with heart failure is 'fluid volume excess.' In heart failure, the heart's reduced pumping ability leads to fluid retention, causing an excess of fluid in the body. This can result in symptoms such as edema, shortness of breath, and weight gain. 'Risk for infection,' 'impaired body temperature,' and 'ineffective airway clearance' are not the most appropriate nursing diagnoses for a patient with heart failure as they do not directly relate to the pathophysiology and common issues seen in heart failure patients.

3. Proteolytic enzymes are most likely to break down which food type?

• A. Carbohydrates
• B. Proteins
• C. Fats
• D. Lipids

Correct answer: B

Rationale: Proteolytic enzymes target proteins for breakdown into amino acids. Carbohydrates are broken down by enzymes like amylase, while fats are broken down by lipase. Lipids, which include fats, are not specifically targeted by proteolytic enzymes.

4. Which of the following should a patient with a history of chronic pancreatitis avoid?

• A. Low-fat dairy
• B. Lean meats
• C. High-fiber vegetables
• D. Alcohol

Correct answer: D

Rationale: The correct answer is D: Alcohol. Alcohol consumption can exacerbate chronic pancreatitis due to its detrimental effects on the pancreas. Conversely, options A, B, and C: Low-fat dairy, Lean meats, and High-fiber vegetables, are generally recommended for patients with chronic pancreatitis. These dietary options are easier on the pancreas and less likely to provoke symptoms. Therefore, they are incorrect choices in this context.

5. A nurse is caring for a client following a CVA and observes the client experiencing severe dysphagia. The nurse notifies the provider. Which of the following nutritional therapies will likely be prescribed?

• A. NPO until dysphagia subsides
• B. Supplements via nasogastric tube
• C. Initiation of total parenteral nutrition
• D. Soft residue diet

Correct answer: B

Rationale: In the scenario of severe dysphagia following a CVA, the client may have difficulty swallowing and require alternative nutritional support. Providing supplements via a nasogastric tube allows for the delivery of essential nutrients directly into the stomach, bypassing the swallowing difficulties. NPO (nothing by mouth) until dysphagia subsides may be too restrictive for the client's nutritional needs. Initiation of total parenteral nutrition is usually reserved for cases where enteral feeding is not possible or contraindicated. A soft residue diet may not be suitable for a client experiencing severe dysphagia.

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