Nursing Elites

1. During the detoxification stage, it is a priority for the nurse to:

• A. teach skills to recognize and respond to health threatening situations
• B. increase the client’s awareness of unsatisfactory protective behaviors
• C. implement behavior modification
• D. promote homeostasis and minimize the client’s withdrawal symptoms

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

2. Each of the following accurately describes aspects of the dietary reference intakes (DRIs) published by the Food and Nutrition Board of the Institute of Medicine (IOM) except one. Which one is the exception?

• A. The DRIs replace the older recommended daily allowances
• B. Current DRIs attempt to estimate required nutrients to improve long-term health
• C. DRIs specifically address individuals whose requirements are affected by a disease state
• D. The DRIs attempt to establish maximum safe levels of tolerance for nutrients

Correct answer: C

Rationale: The correct answer is C. DRIs are intended for the general population and do not specifically address disease states, which are managed with different clinical guidelines. Choice A is correct as DRIs have replaced the older recommended daily allowances. Choice B is correct as current DRIs aim to estimate the required nutrients for long-term health. Choice D is correct as DRIs also attempt to establish maximum safe levels of tolerance for nutrients.

3. The ideal time to begin taking folate to prevent neural tube defects is:

• A. Before conception
• B. Once pregnancy begins
• C. At 6 weeks
• D. Upon completion of the first trimester

Correct answer: A

Rationale: Folate is crucial before conception to prevent neural tube defects. Neural tube development occurs early in pregnancy, often before a woman knows she is pregnant.

4. A nurse is caring for four clients. The nurse should plan to administer total parenteral nutrition for which of the following clients?

• A. A client who is postoperative following a laminectomy and is receiving IV PCA
• B. A client who has dysphagia and does not recognize his family
• C. A client who has COPD and is going home with oxygen
• D. A client who has colon cancer and will undergo a hemicolectomy

Correct answer: D

Rationale: Total parenteral nutrition (TPN) is essential for clients undergoing significant surgical procedures like a hemicolectomy to ensure they receive adequate nutrition when oral intake is not possible. Choices A, B, and C do not typically require TPN. Choice A is managing postoperative pain with IV PCA, choice B is likely to need alternative feeding methods due to dysphagia, and choice C is going home with oxygen for COPD management, which does not directly relate to the need for TPN.

5. What intervention would be most appropriate for a patient who has difficulty eating because of chewing problems?

• A. Use squeeze bottles to pour liquids into the mouth
• B. Provide utensils that have modified handles
• C. Offer plates with food guards
• D. Provide soft foods

Correct answer: D

Rationale: Providing soft foods is crucial for patients with chewing difficulties to ensure they can consume adequate nutrition without discomfort.

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