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 group is least susceptible to insufficient intake of protein?

• A. The elderly
• B. Individuals with low income
• C. Adults participating in endurance exercise
• D. Patients who are chronically ill

Correct answer: C

Rationale: Adults who participate in endurance exercise are typically more aware of their nutritional needs and have higher protein intake compared to other groups. The rationale behind why the other choices are incorrect is as follows: A: The elderly are often at a higher risk of insufficient protein intake due to various factors such as reduced appetite, dental issues, and decreased muscle mass. B: Individuals with low income may struggle to afford protein-rich foods, making them more susceptible to insufficient protein intake. D: Patients who are chronically ill may have specific dietary restrictions or challenges that can lead to inadequate protein consumption.

3. According to the dietary reference intakes, what percentage of your daily calorie intake should ideally come from carbohydrates?

• A. 10-35%
• B. 20-35%
• C. 40-50%
• D. 45-65%

Correct answer: D

Rationale: Carbohydrates should ideally make up 45-65% of your total daily caloric intake, according to the Dietary Reference Intakes (DRIs). This range provides the necessary energy for bodily functions and activities. Choices A, B, and C are incorrect because they fall outside the recommended range for carbohydrate intake based on the DRIs.

4. Because of increasing cases of fluorosis, low levels of fluoride are added to commercial infant formula. Breast milk provides low levels of fluoride.

• 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: D

Rationale: The first statement is false; fluoride is not added to infant formulas due to the risk of fluorosis. The second statement is true; breast milk contains low levels of fluoride.

5. The rationales for using a prostaglandin gel for a client prior to the induction of labor is to:

• A. Soften and efface the cervix
• B. Numb cervical pain receptors
• C. Prevent cervical lacerations
• D. Stimulate uterine contractions

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.

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