Nursing Elites

1. One of the most common factors that compromise the vitamin D status of older adults, particularly those living in assisted living communities is _____.

• A. decreased intake of fruits and vegetables
• B. lack of physical activity
• C. malabsorption due to atrophic gastritis
• D. lack of exposure to sunlight

Correct answer: D

Rationale: The correct answer is 'D: lack of exposure to sunlight.' Older adults, especially those in assisted living communities, are at risk of vitamin D deficiency due to spending most of their time indoors, which reduces their exposure to sunlight. Sunlight is essential for the body to produce vitamin D. Choices A, B, and C are less likely to be major factors in compromising vitamin D status. While a decreased intake of fruits and vegetables and lack of physical activity can impact overall health, they are not as directly related to vitamin D status. Malabsorption due to atrophic gastritis may affect the absorption of certain nutrients, but vitamin D synthesis primarily depends on sunlight exposure.

2. A nurse is reviewing the medication administration record for a client who is 2 days postoperative following abdominal surgery. The nurse should recognize that which of the following medications places the client at risk for wound dehiscence?

• A. Omeprazole
• B. Zolmitriptan
• C. Prednisone
• D. Verapamil

Correct answer: C

Rationale: Corrected Rationale: Prednisone is a corticosteroid that can impair wound healing and increase the risk of wound dehiscence. Omeprazole (Choice A) is a proton pump inhibitor used to reduce stomach acid production and does not directly impact wound healing. Zolmitriptan (Choice B) is a medication used to treat migraines and does not affect wound healing. Verapamil (Choice D) is a calcium channel blocker used to treat high blood pressure and certain heart conditions, and it does not pose a significant risk for wound dehiscence.

3. 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.

4. Patients with this chronic nutrient deficiency may feel tired, weak, and irritable while being unable to pinpoint why. Hypertension, heart attack, stroke, kidney stones, and osteoporosis are associated with the chronic deficiency of which nutrient?

• A. Zinc
• B. Iron
• C. Sodium
• D. Potassium

Correct answer: D

Rationale: The correct answer is D: Potassium. Chronic potassium deficiency can lead to hypertension, heart attack, stroke, kidney stones, and osteoporosis. Patients experiencing this deficiency may feel tired, weak, and irritable without knowing the cause. Choice A (Zinc) is incorrect as zinc deficiency presents with different symptoms. Choice B (Iron) deficiency is associated with anemia symptoms, not the conditions listed. Choice C (Sodium) deficiency typically manifests as muscle cramps, weakness, and confusion, not the conditions described in the question.

5. What is the most appropriate instruction to provide to the parent of a child who does not like a food item?

• A. The child should not be encouraged to try it again.
• B. The child should be offered a reward if they eat most of the food items.
• C. The child should be offered the item at least 8 times on different occasions.
• D. The child should be encouraged to eat at least 5 bites of the food item.

Correct answer: C

Rationale: The correct answer is C. Encouraging repeated exposure to the food item can help the child develop a taste for it. Option A is incorrect as it suggests avoiding encouraging the child to try the food again, which may hinder their ability to develop a liking for it. Option B is incorrect as using rewards for eating may not promote a genuine interest in the food item. Option D is incorrect because setting a specific number of bites may create pressure and negativity around mealtime, rather than fostering a positive association with the food.

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