Nursing Elites

1. A client has a new prescription for total parenteral nutrition (TPN). Which of the following actions should the nurse plan to take?

• A. Obtain a random blood glucose daily.
• B. Change the IV tubing every 72 hours.
• C. Apply a new dressing to the IV site every 24 hours.
• D. Weigh the client weekly.

Correct answer: A

Rationale: When a client is on total parenteral nutrition (TPN), monitoring blood glucose levels daily is crucial to manage and detect complications like hyperglycemia, which can occur due to the high glucose content in TPN solutions. Regular blood glucose monitoring helps the healthcare team adjust the TPN infusion rate to maintain optimal glucose levels and prevent adverse events. Choices B, C, and D are incorrect because changing IV tubing every 72 hours, applying a new dressing to the IV site every 24 hours, and weighing the client weekly are not specific actions directly related to monitoring and managing the effects of TPN, particularly in relation to glucose levels.

2. A client has a new diagnosis of gout, and the nurse is providing dietary management education. Which of the following statements should the nurse include in the teaching?

• A. You should increase your intake of purine-rich foods.
• B. You should decrease your intake of purine-rich foods.
• C. You should avoid foods that contain lactose.
• D. You should increase your intake of dairy products.

Correct answer: B

Rationale: The correct answer is to decrease intake of purine-rich foods to manage uric acid levels and symptoms of gout. Purine-rich foods can exacerbate gout symptoms by increasing uric acid production, leading to flare-ups. Therefore, reducing purine intake is essential in the dietary management of gout. Option A is incorrect because increasing purine-rich foods can worsen gout symptoms. Option C is irrelevant as lactose is not directly related to gout. Option D is incorrect as increasing dairy products is not a recommended dietary modification for managing gout.

3. A healthcare provider is assessing a client who has anemia. Which of the following findings should the healthcare provider expect?

• A. Bradycardia.
• B. Pallor.
• C. Hypertension.
• D. Jaundice.

Correct answer: B

Rationale: Pallor is a common finding in clients with anemia due to decreased hemoglobin levels. Anemia leads to reduced oxygen-carrying capacity in the blood, resulting in pale skin and mucous membranes, which is known as pallor. Bradycardia, hypertension, and jaundice are typically not associated with anemia.

4. A client has been prescribed enoxaparin. Which of the following instructions should the nurse include?

• A. You need to obtain routine blood tests to monitor the effects of this medication.
• B. You should administer the medication into your thigh.
• C. You should inject the medication once daily.
• D. You need to use a 1-inch needle to administer the medication.

Correct answer: C

Rationale: The correct instruction to include when educating a client prescribed enoxaparin is to inject the medication once daily. Enoxaparin is typically administered via subcutaneous injection once daily, usually in the abdomen, to prevent blood clots.

5. A client with a new diagnosis of COPD is being taught about dietary management. Which of the following statements should be included in the teaching?

• A. You should increase your intake of high-calorie foods.
• B. You should decrease your intake of high-protein foods.
• C. You should avoid foods that contain lactose.
• D. You should increase your intake of high-fiber foods.

Correct answer: A

Rationale: The correct statement to include in the teaching for a client with a new diagnosis of COPD is that they should increase their intake of high-calorie foods. This is important to help maintain energy levels and manage weight. COPD can lead to increased energy expenditure due to the increased work of breathing, making it crucial to consume adequate calories for energy. High-calorie foods can help prevent weight loss and support overall nutritional status in COPD patients. Choice B is incorrect because high-protein foods are important for maintaining muscle mass in COPD patients. Choice C is incorrect as there is no need to avoid foods that contain lactose unless the client is lactose intolerant. Choice D is incorrect as increasing high-fiber foods may exacerbate symptoms like bloating and gas in COPD patients.

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