Nursing Elites

1. A nurse is caring for a client who has cancer and is receiving total parenteral nutrition (TPN). Which of the following lab values indicates the treatment is effective?

• A. Hct 43%
• B. WBC 8,000/uL
• C. Albumin 4.2 g/dL
• D. Calcium 9.4 mg/dL

Correct answer: C

Rationale: The correct answer is Albumin 4.2 g/dL. Albumin is a protein produced by the liver and is a key indicator of nutritional status. In a client receiving total parenteral nutrition (TPN), an increase in albumin level indicates that the treatment is effective in providing adequate nutrition support. Hct (hematocrit), WBC (white blood cell count), and calcium levels are not direct indicators of the effectiveness of TPN in this context.

2. A healthcare professional is preparing an education program for a group of parents of adolescents. Which of the following should be included as indicators of nutritional risk among adolescents? (Select one that does not apply.)

• A. Skipping more than three meals per week
• B. Eating fast food once weekly
• C. Eating without family supervision frequently
• D. Frequently skipping breakfast

Correct answer: B

Rationale: Among the indicators of nutritional risk among adolescents, skipping meals, eating without family supervision, and frequently skipping breakfast are commonly associated with poor nutrition. However, eating fast food once weekly may not necessarily indicate a significant nutritional risk, as occasional consumption of fast food in moderation is not uncommon among adolescents. This choice is the correct answer because it does not strongly correlate with nutritional risk compared to the other options provided.

3. Which ethnic group has the lowest rates of type 2 diabetes?

• A. Caucasians
• B. Asian Indians
• C. Pacific Islanders
• D. African Americans

Correct answer: A

Rationale: Statistical data suggest that Caucasians generally have lower rates of type 2 diabetes compared to the other ethnic groups listed in the choices. This is not to say that Caucasians are immune to the disease, but rather that they have fewer reported instances. On the other hand, African Americans and Pacific Islanders are often identified as groups with a significantly higher risk and prevalence of type 2 diabetes. Asian Indians also exhibit higher rates compared to Caucasians. It is important to note that these are general trends observed in statistical data, and individual health outcomes can vary based on various factors such as lifestyle, diet, and genetics, among others. Therefore, the correct answer is A: Caucasians because they generally have the lowest rates of type 2 diabetes when compared to the other ethnic groups mentioned.

4. Low levels of high-density lipoproteins (HDL) are?

• A. associated with being underweight
• B. more prevalent in males
• C. highly predictive of CHD risk
• D. not a good predictor of CHD risk

Correct answer: C

Rationale: Low levels of HDL cholesterol are a strong predictor of coronary heart disease (CHD) risk because HDL helps to remove excess cholesterol from the bloodstream. Choice A is incorrect because low HDL levels are not associated with being underweight but rather with increased CHD risk. Choice B is incorrect as low HDL levels are not more prevalent in males but can affect both genders. Choice D is incorrect as low levels of HDL are indeed a good predictor of CHD risk.

5. For a patient on a ketogenic diet, which macronutrient is primarily increased?

• A. Carbohydrates
• B. Protein
• C. Fats
• D. Fiber

Correct answer: C

Rationale: The correct answer is C: Fats. A ketogenic diet is characterized by high fat intake, moderate protein intake, and very low carbohydrate intake. This diet aims to shift the body's metabolism to use fat as the primary source of energy instead of carbohydrates. Increasing fat intake while reducing carbohydrates is essential for achieving and maintaining a state of ketosis. Therefore, choices A, B, and D are incorrect as they do not align with the macronutrient adjustments required for a ketogenic diet.

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