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. Tony is to be discharged in the afternoon of the same day after tonsillectomy and adenoidectomy. You, as the RN, will make sure that the family knows to:

• A. offer pureed foods
• B. offer soft foods for a week to minimize discomfort while swallowing
• C. supplement his diet with Vitamin C-rich foods to enhance healing
• D. offer clear liquids for 3 days to prevent irritation

Correct answer: B

Rationale: After tonsillectomy and adenoidectomy, it is crucial to provide soft foods for a week to minimize discomfort while swallowing. This helps prevent irritation to the surgical site and allows for easier healing. Offering pureed foods (Choice A) may not be necessary as soft foods are usually sufficient. While Vitamin C is beneficial for healing, it is not necessary to supplement it immediately after surgery with Vitamin C-rich juices (Choice C). Clear liquids are typically recommended before surgery and not after, as the focus shifts to soft foods to aid in recovery, making Choice D incorrect.

3. After surgery Leda develops peripheral numbness, tingling and muscle twitching and spasm. What would you anticipate to administer?

• A. Magnesium sulfate C. Potassium iodide
• B. Calcium gluconate D. Potassium chloride
• C.
• D.

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.

4. Which statement about essential nutrients should the nurse include?

• A. Fat-containing foods can help to decrease triglyceride levels.
• B. Animal sources of protein contain 20 essential amino acids.
• C. Carbohydrates are the primary source of fuel for muscles and the brain.
• D. High-fiber foods are a good source of energy.

Correct answer: C

Rationale: The correct answer is C because carbohydrates are indeed the primary source of fuel for muscles and the brain. Choice A is incorrect because while certain fats are essential, they do not help decrease triglyceride levels. Choice B is incorrect because animal sources of protein do not contain all 20 essential amino acids. Choice D is incorrect because although high-fiber foods are important for digestion and overall health, they are not a direct source of energy.

5. A nurse is instructing the mother of a toddler who has iron-deficiency anemia to increase iron in the child's diet in addition to the prescribed iron supplement. Which of the following foods should the nurse recommend?

• A. Skim milk
• B. Bananas
• C. Tuna fish
• D. Cucumbers

Correct answer: C

Rationale: Tuna fish is a good source of iron and would be beneficial for a toddler with iron-deficiency anemia. Skim milk, bananas, and cucumbers are not significant sources of iron and would not help in increasing the iron levels in the child's diet. Skim milk, in particular, can inhibit iron absorption due to its calcium content, which is important for the nurse to educate the mother about.

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