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 drug is most likely to cause unintentional weight gain?

• A. Antiemetics
• B. Sedatives
• C. Corticosteroids
• D. Antibiotics

Correct answer: C

Rationale: Corticosteroids are most likely to cause unintentional weight gain. They influence the metabolism and fat distribution in the body, leading to weight gain. On the other hand, antiemetics are drugs that are used to prevent nausea and vomiting, and they do not typically cause weight gain. Sedatives, while they can cause drowsiness and may lead to less physical activity, are not directly associated with weight gain. Lastly, antibiotics are used to fight bacteria and while they can cause temporary digestive issues, they do not typically result in long-term weight gain.

3. A nurse is providing teaching to a group of parents of newborns who are planning to formula feed. Which of the following statements by a parent indicates a need for further teaching?

• A. "I will give formula to my baby at room temperature."
• B. "I will ensure my baby's feeds last 10 to 15 minutes."
• C. "I will burp my baby halfway through each feeding."
• D. "I will watch for signs my baby is full and stop the feeding."

Correct answer: B

Rationale: The correct answer is, "I will ensure my baby's feeds last 10 to 15 minutes." This statement indicates a need for further teaching because it suggests a strict time limit for feedings, which may not be appropriate for a newborn. Newborns should be allowed to feed as long as they want, typically around 20-30 minutes per breast if breastfeeding, or on-demand with formula. Choices A, C, and D demonstrate proper feeding practices such as feeding at room temperature, burping halfway through each feeding, and watching for signs of fullness to stop the feeding, which are all appropriate responses by a parent of a formula-fed newborn.

4. A healthcare provider is assessing a client who has a stage III pressure ulcer that is healing poorly. The provider should identify that which of the following vitamin deficiencies increases the client’s risk for delayed wound healing?

• A. Vitamin C
• B. Vitamin D
• C. Vitamin E
• D. Vitamin B6

Correct answer: A

Rationale: Corrected Rationale: Vitamin C deficiency can impair collagen synthesis and delay wound healing, making it crucial for recovery from pressure ulcers. Incorrect Rationales: - Vitamin D deficiency is associated with bone health, not specifically wound healing. - Vitamin E deficiency can lead to neurological and immune system issues but is not directly linked to delayed wound healing. - Vitamin B6 deficiency can cause skin rashes and neurological symptoms but is not a primary factor in delayed wound healing.

5. A nurse is completing an admission assessment on an adolescent client who is a vegetarian. He eats milk products but does not like beans. Which of the following items should the nurse suggest the client order for lunch to provide the nutrients most likely to be lacking in his diet?

• A. Peanut butter and jelly sandwich
• B. Baked potato topped with sour cream
• C. Bagel with cream cheese
• D. Fruit salad

Correct answer: D

Rationale: The correct answer is 'Fruit salad.' Since the adolescent client is a vegetarian who eats milk products but does not like beans, suggesting a fruit salad for lunch would provide essential nutrients like vitamins, minerals, and fiber that are commonly found in fruits. Fruit salad can help supplement the nutrients that may be lacking in his diet. Choices A, B, and C do not offer the same variety and quantity of nutrients as a fruit salad, making them less optimal choices for meeting the client's dietary needs.

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