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. Which type of medication is most likely to induce xerostomia?

• A. Antibiotics
• B. Diuretics
• C. Local anesthetics
• D. Anticholinergics

Correct answer: D

Rationale: The correct answer is D, Anticholinergics. Anticholinergic medications commonly cause xerostomia by inhibiting saliva production, leading to dry mouth. Antibiotics (choice A) are not typically associated with xerostomia. Diuretics (choice B) increase urine production but do not directly affect saliva production. Local anesthetics (choice C) are used to numb specific areas during dental procedures and do not induce xerostomia.

3. A nurse is developing a plan of care for a client who has anorexia nervosa. Which of the following actions should the nurse include in the plan?

• A. Encourage the client to participate in developing a system of rewards.
• B. Arrange for someone to remain with the client for 30 minutes after meals.
• C. Offer the client a selection of beverages at each meal.
• D. Inform the client that a weight gain of 2.3 kg per week is expected.

Correct answer: A

Rationale: Encouraging the client to participate in developing a system of rewards is an essential part of the plan of care for a client with anorexia nervosa. This action can help motivate and engage the client in their treatment plan, promoting a sense of achievement and progress. Choice B, arranging for someone to remain with the client for 30 minutes after meals, may not address the underlying issues related to anorexia nervosa and could potentially disrupt the client's independence. Choice C, offering a selection of beverages at each meal, is not directly related to addressing the client's condition of anorexia nervosa. Choice D, informing the client about an expected weight gain, could increase anxiety and may not be appropriate without considering the client's individual progress and readiness.

4. A client with anorexia undergoing radiation therapy is being taught by a nurse. Which instruction should the nurse include in the teaching?

• A. Limit high-calorie supplements to between meals
• B. Avoid overeating during your 'good' days
• C. Eat hot foods instead of cold foods
• D. Consume nutrient-dense foods first

Correct answer: D

Rationale: The correct instruction for a client with anorexia undergoing radiation therapy is to consume nutrient-dense foods first. This ensures that the client receives the necessary calories and nutrients. Option A is incorrect because high-calorie supplements should not be limited but rather incorporated wisely into the diet. Option B is incorrect as overeating is not recommended regardless of the type of day. Option C is incorrect as there is no specific preference for hot foods over cold foods in managing anorexia during radiation therapy.

5. After bronchoscopy, the nurse's priority is to check which of the following before feeding?

• A. Gag reflex
• B. Wearing off of anesthesia
• C. Swallowing reflex
• D. Peristalsis

Correct answer: A

Rationale: After a bronchoscopy procedure, the nurse's priority is to check the patient's gag reflex before allowing them to eat to prevent aspiration. The gag reflex helps protect the airway by triggering a cough or gag response if something touches the back of the throat. This is crucial to ensure that the patient can protect their airway and prevent food or fluids from entering the lungs, especially when the throat may be sensitive or compromised post-bronchoscopy. Checking for the wearing off of anesthesia, swallowing reflex, or peristalsis are important assessments but not the immediate priority before feeding in this context.

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