Nursing Elites

1. What is the most likely complication for a client receiving TPN who suddenly develops tremors, dizziness, and diaphoresis?

• A. Fluid volume overload
• B. Sepsis
• C. Hyperglycemia
• D. Hypoglycemia

Correct answer: D

Rationale: The correct answer is D, Hypoglycemia. When a client receiving TPN suddenly develops tremors, dizziness, and diaphoresis, it is indicative of hypoglycemia. TPN provides a high concentration of glucose, and if it is abruptly stopped or the infusion rate is reduced, it can lead to hypoglycemia. Choices A, B, and C are incorrect as they do not directly correlate with the symptoms described in the scenario. Fluid volume overload typically presents with edema and hypertension, sepsis with fever and increased heart rate, and hyperglycemia with polyuria, polydipsia, and blurred vision.

2. What is the desirable resting systolic blood pressure for adults?

• A. <130 mmHg>
• B. <105 mmHg>
• C. <120 mmHg>
• D. <140 mmHg>

Correct answer: C

Rationale: The desirable resting systolic blood pressure for adults is less than 120 mmHg. This blood pressure is associated with a lower risk of cardiovascular disease. Measurements higher than 120 mmHg (choices A and D) indicate elevated blood pressure, which can lead to hypertension and other health complications if not managed. A reading of less than 105 mmHg (choice B) could indicate low blood pressure, which also poses health risks such as dizziness and fainting.

3. What physiologic role does magnesium play in the body?

• A. Blood clotting, transmission of nerve impulses, muscle contraction and relaxation
• B. Calcium homeostasis, structural integrity of heart muscle
• C. No known metabolic function, caries-preventing properties
• D. ATP energy release; metabolism of fats, carbohydrates, proteins; regulates acid-base balance

Correct answer: B

Rationale: The correct answer is B. Magnesium plays an important role in maintaining calcium homeostasis and preventing skeletal abnormalities. It is involved in more than 300 enzymatic reactions, including energy metabolism, insulin activity, and glucose use. Magnesium is vital to the structural integrity of heart muscle and other muscles and nerves. While magnesium does play a role in blood clotting, nerve impulses, muscle contraction, relaxation, ATP energy release, and metabolism of fats, carbohydrates, proteins, the primary physiologic role of magnesium in the body is related to calcium homeostasis and maintaining the structural integrity of the heart muscle. Choice A is incorrect because it includes functions of magnesium, but they are not its primary physiologic role. Choice C is incorrect as magnesium has several known metabolic functions. Choice D is incorrect because although magnesium is involved in ATP energy release and metabolism, its primary role is related to calcium homeostasis and structural integrity of muscle.

4. A client who has dumping syndrome following a hemi-colectomy should avoid which of the following foods when receiving nutritional teaching from a nurse?

• A. Rice
• B. Poached eggs
• C. Fresh apples
• D. White bread

Correct answer: C

Rationale: Fresh apples should be avoided by a client with dumping syndrome following a hemi-colectomy because they are high in fiber and can exacerbate gastrointestinal symptoms such as diarrhea and bloating. Rice and poached eggs are good options as they are easily digestible and less likely to trigger dumping syndrome symptoms. White bread is also preferable over whole grain bread due to its lower fiber content, making it a better choice for individuals with dumping syndrome.

5. As a nurse, you can help improve the effectiveness of communication among healthcare givers by:

• A. Use of reminders of ‘what to do’
• B. Using standardized list of abbreviations, acronyms, and symbols
• C. One-on-one oral endorsement
• D. Text messaging and e-mail

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

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