Nursing Elites

1. Which set of guidelines is intended to assess nutrient adequacy or plan intakes of population groups, not individuals?

• A. Old Recommended Dietary Allowances (RDA)
• B. Estimated Average Requirement (EAR)
• C. New Recommended Dietary Allowances (RDA)
• D. Tolerable Upper Intake Level (UL)

Correct answer: B

Rationale: The Estimated Average Requirement (EAR) is specifically designed to assess nutrient adequacy or plan intakes for population groups, not for individuals. The Old and New Recommended Dietary Allowances (RDA) are meant for individuals, not groups, as they provide guidelines for specific nutrient intake levels for healthy individuals. The Tolerable Upper Intake Level (UL) is used to set the highest level of nutrient intake that is likely to pose no risk of adverse health effects for most individuals in a group, which is different from assessing nutrient adequacy for groups.

2. 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.

3. As the head nurse in the OR, how can you improve the effectiveness of clinical alarm systems?

• A. Limit suppliers to a few so that quality is maintained
• B. Implement a regular inventory of supplies and equipment
• C. Adherence to manufacturer’s recommendation
• D. Implement a regular maintenance and testing of alarm systems

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

4. A healthcare professional is reviewing the lab results of a client who has bulimia nervosa. The professional should notify the provider of which of the following results?

• A. White Blood Cells 5,200/mm³
• B. Hemoglobin 14 g/dL
• C. Magnesium 1.6 mg/dL
• D. Potassium 3.2 mEq/L

Correct answer: D

Rationale: A potassium level of 3.2 mEq/L is below normal and requires provider notification, especially in clients with bulimia nervosa who are at risk of electrolyte imbalances. Low potassium levels can lead to serious complications like cardiac arrhythmias. The other options are within or close to the normal range and would not be a priority for notification.

5. What is the major diet-derived antioxidant found in cell membranes?

• A. B12
• B. beta-carotene
• C. vitamin E
• D. vitamin A

Correct answer: C

Rationale: The correct answer is vitamin E. Vitamin E is the major antioxidant found in cell membranes, where it plays a crucial role in protecting them from oxidative damage. Although B12, beta-carotene, and vitamin A are important nutrients with specific functions in the body, they are not the primary antioxidants found in cell membranes. Vitamin E specifically localizes in cell membranes to neutralize free radicals and prevent lipid peroxidation, making it an essential antioxidant for cellular health.

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