Nursing Elites

1. A nurse is caring for a client following a CVA and observes the client experiencing severe dysphagia. The nurse notifies the provider. Which of the following nutritional therapies will likely be prescribed?

• A. NPO until dysphagia subsides
• B. Supplements via nasogastric tube
• C. Initiation of total parenteral nutrition
• D. Soft residue diet

Correct answer: B

Rationale: In the scenario of severe dysphagia following a CVA, the client may have difficulty swallowing and require alternative nutritional support. Providing supplements via a nasogastric tube allows for the delivery of essential nutrients directly into the stomach, bypassing the swallowing difficulties. NPO (nothing by mouth) until dysphagia subsides may be too restrictive for the client's nutritional needs. Initiation of total parenteral nutrition is usually reserved for cases where enteral feeding is not possible or contraindicated. A soft residue diet may not be suitable for a client experiencing severe dysphagia.

2. Which is NOT a characteristic or function of lipids?

• A. Involved in energy metabolism and storage
• B. Provide insulation and protection
• C. Act as hormones that regulate the body
• D. Are hydrophilic

Correct answer: D

Rationale: Lipids are known for several functions including involvement in energy metabolism and storage (Choice A), providing insulation and protection (Choice B), and acting as hormones that regulate the body (Choice C). However, lipids are not hydrophilic (water-attracting), contrary to choice D. They are actually hydrophobic, meaning they repel water and do not mix well with it. This is a key property that differentiates them from many other biological molecules.

3. What is the form in which energy from excess intake of proteins, fats, alcohol, and carbohydrates is stored?

• A. Protein
• B. Fat
• C. Carbohydrates
• D. Alcohol

Correct answer: B

Rationale: When the body consumes more energy than it needs, the surplus is stored as fat, regardless of whether the energy source was proteins, fats, alcohol, or carbohydrates. This is why the correct answer is 'Fat'. Other choices are incorrect because, in excess intake situations, the body does not store surplus energy as proteins, carbohydrates, or alcohol.

4. Nonnutritive sweeteners are not metabolized by microorganisms and do not promote dental caries. Products made with a nonnutritive sweetener can be used as frequently as 8 to 10 times per day.

• A. Both statements are true
• B. Both statements are false
• C. The first statement is true; the second is false
• D. The first statement is false; the second is true

Correct answer: C

Rationale: The first statement is true; nonnutritive sweeteners do not promote caries. However, the second statement is false because products with nonnutritive sweeteners should still be consumed in moderation.

5. A client receiving total parenteral nutrition (TPN is awaiting the next container. What fluid should the nurse infuse in the interim?

• A. Dextrose 5% in water
• B. 0.9% sodium chloride
• C. Dextrose 10% in water
• D. Lactated Ringer's solution

Correct answer: B

Rationale: The correct answer is 0.9% sodium chloride. When a client receiving TPN is awaiting the next container, infusing 0.9% sodium chloride is the appropriate choice to maintain fluid and electrolyte balance. Dextrose solutions are not recommended as they do not provide sufficient nutrition. Lactated Ringer's solution contains electrolytes but lacks essential nutrients found in TPN, making it an inadequate choice during the delay in TPN delivery.

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