Nursing Elites

1. A client with chronic pancreatitis is receiving discharge teaching from a nurse. Which of the following statements should the nurse make?

• A. "You should decrease your caloric intake when experiencing abdominal pain."?
• B. "You should increase your daily intake of protein."?
• C. "You should increase fat intake when experiencing loose stools."?
• D. "You should limit alcohol intake to 2-3 drinks per week."?

Correct answer: B

Rationale: In chronic pancreatitis, it is important to increase protein intake to support healing and prevent malnutrition. Choice A is incorrect because decreasing caloric intake during abdominal pain may lead to further nutritional deficiencies. Choice C is incorrect as increasing fat intake can exacerbate symptoms due to the impaired fat digestion in chronic pancreatitis. Choice D is incorrect as alcohol should be completely avoided in chronic pancreatitis to prevent further damage to the pancreas.

2. The nurse is working with a patient who recently had a stroke. The patient frequently chokes and coughs when eating and is having difficulty feeding herself. What is the best way to ensure adequate nutrition?

• A. to have an aide feed her at each meal
• B. to ask a family member to assist during meals
• C. to provide tube feedings for the patient
• D. to initiate TPN for the patient

Correct answer: C

Rationale: The best way to ensure adequate nutrition for a stroke patient who frequently chokes and coughs when eating and has difficulty feeding herself is to provide tube feedings. Tube feedings are a safe and effective method to deliver nutrition directly to the stomach or intestines, bypassing the swallowing mechanism, reducing the risk of aspiration. Having an aide feed her each meal (choice A) may not address the underlying issue of swallowing difficulty and aspiration risk. Asking a family member to be present at each meal (choice B) does not provide a definitive solution to the patient's nutritional needs. Placing the patient on total parenteral nutrition (TPN) (choice D) is a more invasive and typically reserved for patients who cannot tolerate enteral feedings or have non-functional gastrointestinal tracts.

3. What dietary factor raises triglyceride levels?

• A. high refined carbohydrate intake
• B. low soluble fiber intake
• C. high iron intake
• D. low fat intake

Correct answer: A

Rationale: The correct answer is A: high refined carbohydrate intake. High intake of refined carbohydrates, such as sugars and white flour, can lead to elevated triglyceride levels, increasing the risk of cardiovascular disease. Choice B, low soluble fiber intake, is incorrect because soluble fiber actually helps lower triglyceride levels. Choice C, high iron intake, is incorrect as iron intake is not directly linked to raising triglyceride levels. Choice D, low fat intake, is also incorrect as not all fats raise triglyceride levels; it depends on the type of fat consumed.

4. Which of the following has the greatest effect on an increase in body weight?

• A. Carbohydrate intake
• B. Protein intake
• C. Fat intake
• D. Total kilocalories

Correct answer: D

Rationale: Total kilocalories have the greatest effect on body weight as they represent the overall energy intake from all macronutrients combined. While the consumption of specific macronutrients like carbohydrates, proteins, and fats can affect weight management, the total calories consumed play the most significant role in determining body weight. Therefore, choices A, B, and C are incorrect as they focus on individual macronutrients rather than the overall energy balance provided by total kilocalories.

5. Before administration of blood and blood products, the nurse should first:

• A. Check with another R.N the client’s name, Identification number, ABO and RH type.
• B. Explain the procedure to the client
• C. Assess baseline vital signs of the client
• D. Check for the BT order

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

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