Nursing Elites

1. All of the following are electrolytes except:

• A. chloride
• B. potassium
• C. sodium
• D. iron

Correct answer: D

Rationale: Iron is not an electrolyte; electrolytes like sodium, potassium, and chloride help maintain fluid balance and are critical for nerve and muscle function.

2. Patients with kidney stones should increase their intake of:

• A. fluids
• B. vitamin C
• C. oxalates
• D. protein

Correct answer: A

Rationale: Patients with kidney stones should increase their intake of fluids. Increasing fluid intake helps to dilute the urine and reduce the risk of kidney stones forming by flushing out minerals that can crystallize. This promotes the passage of small stones and helps prevent the formation of new ones. Vitamin C and protein intake should be moderated as excessive consumption may lead to the formation of certain types of kidney stones. Oxalates should be limited in the diet as they can contribute to the formation of calcium oxalate stones, a common type of kidney stone.

3. 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.

4. A client with cholecystitis is being taught about required dietary modifications. Which of the following foods is appropriate for the client's diet?

• A. Creamed chicken
• B. Roast turkey
• C. Ice cream
• D. Macaroni and cheese

Correct answer: B

Rationale: Roast turkey is the most appropriate choice for a client with cholecystitis. Foods that are high in fat content, like creamed chicken, ice cream, and macaroni and cheese, should be avoided in cholecystitis as they can exacerbate symptoms due to the reduced ability of the gallbladder to process fats. Roast turkey is a leaner option that is better tolerated by individuals with cholecystitis.

5. Which condition is most closely associated with a high rate of gastroesophageal reflux disease?

• A. Pregnancy
• B. Anorexia
• C. Hypertension
• D. Diabetes mellitus

Correct answer: A

Rationale: Pregnancy is the correct answer as it is most closely associated with a high rate of gastroesophageal reflux disease (GERD). During pregnancy, the growing fetus exerts pressure on the stomach, leading to the backflow of stomach acid into the esophagus, causing GERD. This physiological change is a common occurrence in pregnant individuals. Conversely, anorexia, hypertension, and diabetes mellitus are not typically linked to a high rate of GERD. While these conditions have their own effects on the body, they do not directly contribute to the mechanisms that cause GERD, unlike the physical changes associated with pregnancy. Therefore, choices B, C, and D are incorrect.

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