Nursing Elites

1. 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.

2. James wants to know the recommended intake for iron for his gender and age. Which of the following would provide the best answer for James?

• A. EAR
• B. UL
• C. RDA
• D. DV

Correct answer: C

Rationale: The Recommended Dietary Allowance (RDA) is the correct answer for James because it provides the daily intake level that meets the nutrient needs of most healthy individuals in a specific age and gender group. Choice A, EAR (Estimated Average Requirement), represents the average daily nutrient intake level estimated to meet the requirement of half the healthy individuals in a particular life stage and gender group. Choice B, UL (Tolerable Upper Intake Level), is the maximum daily intake unlikely to cause adverse health effects. Choice D, DV (Daily Value), is a general guide used for food labeling that represents how much a nutrient in a serving of food contributes to a daily diet based on a 2000-calorie daily intake.

3. Mr. CKK is unconscious and was brought to the E.R. Who among the following can give consent for CKK's operation?

• A. Doctor
• B. Nurse
• C. Next of Kin
• D. The Patient

Correct answer: A

Rationale: In the scenario described, when a patient is unconscious and unable to provide consent, the responsibility usually falls on the physician to make decisions regarding the patient's treatment, including obtaining consent for an operation. While nurses play a crucial role in patient care, they typically do not have the authority to provide consent for a major procedure. The next of kin may be consulted for input, but the ultimate decision-making authority lies with the physician. The patient, being unconscious, is unable to provide consent in this situation.

4. A client has acute dysphagia. Which of the following nursing interventions should be included in the plan of care?

• A. Providing a straw for consumption of liquids
• B. Encouraging larger bites
• C. Placing the client in semi-Fowler's position during meals
• D. Instructing the client to tilt head forward when swallowing

Correct answer: C

Rationale: Placing the client in semi-Fowler's position during meals is the correct intervention for a client with acute dysphagia. This position helps prevent aspiration by facilitating swallowing. Providing a straw for consumption of liquids (Choice A) can increase the risk of aspiration and is not recommended for clients with dysphagia. Encouraging larger bites (Choice B) can also increase the risk of choking and aspiration. Instructing the client to tilt the head forward when swallowing (Choice D) is not the recommended technique for managing dysphagia as it does not address the underlying issue effectively.

5. Which type of diabetes is often associated with a BMI greater than 25 and an increased percentage of body fat, particularly in the abdominal region, contributing to insulin resistance?

• A. Type 1 Diabetes
• B. Type 2 Diabetes
• C. Gestational Diabetes
• D. Prediabetes

Correct answer: B

Rationale: The correct answer is B. Type 2 Diabetes is often associated with a BMI greater than 25 and an increased percentage of body fat, particularly in the abdominal region, contributing to insulin resistance. Type 1 Diabetes is an autoimmune condition not primarily linked to BMI or body fat percentage. Gestational Diabetes occurs during pregnancy and is not directly related to BMI. Prediabetes is a condition where blood sugar levels are higher than normal but not high enough to be diagnosed as Type 2 Diabetes; although it can be associated with higher BMI, it is not as definitive as in Type 2 Diabetes.

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