Nursing Elites

1. A client who underwent surgical placement of a colostomy is being cared for by a nurse. Which of the following statements indicates the client understands the dietary teaching?

• A. “Eating yogurt can help decrease the amount of gas that I have.”
• B. “I should eliminate pasta from my diet so that I don’t have as many loose stools.”
• C. “My largest meal of the day should be in the evening.”
• D. “Carbonated beverages can help control odor.”

Correct answer: “Carbonated beverages can help control odor.”

Rationale: The correct answer is D. Carbonated beverages can help control odor in clients with colostomies. This is because carbonated drinks can help decrease odor by reducing the production of odoriferous compounds in the colon. Choices A, B, and C are incorrect. Eating yogurt may help regulate bowel movements but does not specifically address odor control associated with colostomies. Eliminating pasta from the diet to reduce loose stools is not necessary for colostomy care. The timing of the largest meal of the day is not directly related to dietary teaching for colostomy care.

2. 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: 0.9% sodium chloride

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.

3. Which of the following has the greatest effect on an increase in body weight?

• A. Carbohydrate intake
• B. Protein intake
• C. Fat intake
• D. Total kilocalories

Correct answer: D

Rationale: Total kilocalories have the greatest effect on body weight as they represent the overall energy intake from all macronutrients combined. While the consumption of specific macronutrients like carbohydrates, proteins, and fats can affect weight management, the total calories consumed play the most significant role in determining body weight. Therefore, choices A, B, and C are incorrect as they focus on individual macronutrients rather than the overall energy balance provided by total kilocalories.

4. Which of the following nursing interventions is appropriate after a total thyroidectomy?

• A. Place pillows under your patient’s shoulders.
• B. Raise the knee-gatch to 30 degrees
• C. Keep you patient in a high-fowler’s position.
• D. Support the patient’s head and neck with pillows and sandbags.

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.

5. What differentiates one amino acid from another?

• A. The amine group
• B. The acid group
• C. The side chain
• D. None of the above

Correct answer: C: The side chain

Rationale: The side chain, also known as the R group, is what differentiates one amino acid from another. It imparts unique properties to each amino acid, thereby influencing their roles and functions in proteins. The amine group (Choice A) and the acid group (Choice B) are components of all amino acids and do not cause the differences among various amino acids. Choice D is incorrect as it suggests that none of the given options account for the differences, which is not true as the side chain does.

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