Nursing Elites

1. A client is being prepared for placement of a catheter for total parenteral nutrition. Which of the following access sites should be planned for catheter insertion?

• A. Left antecubital vein
• B. Right subclavian vein
• C. Right femoral artery
• D. Left arm radial artery

Correct answer: B

Rationale: The correct answer is the Right subclavian vein. When preparing a client for placement of a catheter for total parenteral nutrition, the preferred access site for catheter insertion is the subclavian vein due to its large size, central location, and lower risk of infection compared to peripheral veins. The other options provided (Left antecubital vein, Right femoral artery, and Left arm radial artery) are not suitable access sites for central venous catheter insertion for total parenteral nutrition.

2. What is the fundamental difference between nursing diagnoses and collaborative problems?

• A. Collaborative problems are managed by nurses using physician-prescribed interventions.
• B. Collaborative problems can be addressed by independent nursing interventions.
• C. Physician-prescribed interventions are incorporated into nursing diagnoses.
• D. Nursing diagnoses include physiologic complications that nurses monitor to detect status changes.

Correct answer: B

Rationale: The correct answer is B, as collaborative problems necessitate the collective expertise and skills of numerous healthcare professionals, including nurses. These problems can be dealt with through independent nursing interventions in cooperation with other team members. Option A is incorrect because collaborative problems aren't strictly managed with physician-prescribed interventions. Option C is incorrect because nursing diagnoses aim at identifying and treating actual or potential health issues, rather than merely integrating physician-prescribed interventions. Option D is incorrect because nursing diagnoses aim at identifying patient issues, not solely physiologic complications, and guide the necessary nursing care, not just monitor for changes.

3. Which nutrients might people who follow a vegan diet be deficient in?

• A. Vitamin B12
• B. Vitamin C
• C. Vitamins A and D
• D. Calcium

Correct answer: C

Rationale: People who adhere to a vegan diet might indeed be deficient in vitamins A and D, which are primarily found in animal-derived foods. While vitamin B12 and calcium can also be lacking in a vegan diet, these were not choices given that would correctly answer the question. Vitamin C, on the other hand, is widely available in numerous plant-based foods, making it less likely for vegans to be deficient in it. Therefore, the correct answer is 'Vitamins A and D'. It's important to note that deficiencies can be avoided through careful meal planning or supplementation.

4. A nurse is discussing denture care with the partner of a client who is unable to perform oral hygiene. Which of the following should be included in the discussion?

• A. Floss dentures as part of daily cleaning.
• B. Wipe dentures before storing them in a dry container at night.
• C. Wrap gloved fingers with gauze to remove dentures.
• D. Use a washcloth to clean the denture surfaces.

Correct answer: C

Rationale: The correct answer is C: 'Wrap gloved fingers with gauze to remove dentures.' This method provides a safe and effective way to remove dentures without causing damage. Choice A is incorrect because flossing dentures is not recommended. Choice B is incorrect as it suggests wiping dentures and storing them dry, which is not the best practice. Choice D is incorrect because using a washcloth may not effectively clean all denture surfaces.

5. Any disease that produces ____ malabsorption can bring about deficiencies of vitamins A, D, E, and K.

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

Correct answer: C

Rationale: Vitamins A, D, E, and K are fat-soluble, meaning they require fat for absorption. Diseases that cause fat malabsorption can lead to deficiencies in these vitamins.

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