Nursing Elites

1. What is the purpose of a chest tube after a lobectomy procedure, as understood by the nurse?

• A. Prevent mediastinal shift
• B. Promote chest expansion of the remaining lung
• C. Drain fluids and blood accumulated post-operatively
• D. Remove the air in the lungs to promote lung expansion

Correct answer: C

Rationale: After a lobectomy, a chest tube is typically inserted to drain fluids and blood that may have accumulated post-operatively. This tube helps to prevent complications, such as infections or pneumonia, and aids in patient recovery. While a chest tube may aid in preventing a mediastinal shift (Choice A), promoting chest expansion of the remaining lung (Choice B), and removing air in the lungs to promote lung expansion (Choice D), these are not the primary reasons for its use after a lobectomy. Therefore, Choices A, B, and D are incorrect.

2. What best describes a task of the registered dietitian?

• A. administering total parenteral nutrition
• B. administering formula through feeding tubes
• C. prescribing diet orders
• D. conducting nutrition assessments

Correct answer: D

Rationale: The correct answer is D, conducting nutrition assessments. Registered dietitians are responsible for assessing an individual's nutritional status, dietary intake, and health needs. This assessment forms the basis for developing personalized nutrition care plans. Choices A and B involve the administration of specialized nutrition support, which is typically done by healthcare providers with specific training in those areas. Choice C, prescribing diet orders, may fall outside the scope of practice for a dietitian as they focus more on assessment, education, and counseling related to nutrition rather than prescribing medical treatments.

3. A client is prescribed a 1500-calorie diet. Thirty percent of the calories are to be derived from fat. How many grams of fat should the nurse tell the client to consume per day? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

• A. 21
• B. 49
• C. 60
• D. 50

Correct answer: D

Rationale: To calculate the grams of fat, first, determine the calories from fat by multiplying the total calorie intake (1500 calories) by the percentage of calories from fat (30%), which equals 450 calories from fat. Since 1 gram of fat is equivalent to 9 calories, divide the total calories from fat (450) by the calories in 1 gram of fat (9) to get the answer in grams, which is 50. Therefore, the client should consume 50 grams of fat per day. Choice A (21), Choice B (49), and Choice C (60) are incorrect as they do not reflect the accurate calculation based on the given information.

4. 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.

5. What instruction should the nurse include on weight gain during pregnancy?

• A. Failure to obtain the required weight gain during pregnancy will increase the risk of preterm birth.
• B. An obese client needs to gain as much weight as a client with a normal body mass index.
• C. A client with a normal body mass index should plan on gaining 50 pounds.
• D. Clients will need to eat for two when they are pregnant.

Correct answer: A

Rationale: Appropriate weight gain is crucial for reducing the risk of preterm birth.

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