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. Which of the following terms refers to weakness of both legs and the lower part of the trunk?

• A. Paraparesis
• B. Hemiplegia
• C. Quadriparesis
• D. Paraplegia

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

3. Why do older adult female clients need less iron than younger adult female clients?

• A. The need for iron decreases because older female clients produce more red blood cells.
• B. The need for iron decreases with age because older female clients carry oxygen more efficiently.
• C. The need for iron decreases with age because older female clients experience menopause.
• D. The need for iron decreases with age because older female clients exercise more.

Correct answer: C

Rationale: The correct answer is C. Older adult female clients need less iron than younger adult female clients because as women go through menopause, they no longer lose blood through menstruation, leading to a reduced need for iron. Choice A is incorrect because producing more red blood cells does not directly correlate with needing less iron. Choice B is incorrect as carrying oxygen more efficiently does not necessarily decrease the need for iron. Choice D is incorrect as exercising more does not explain the decreased need for iron in older adult female clients.

4. You will do nasopharyngeal suctioning on Mr. Abad. Your guide for the length of insertion of the tubing for an adult would be:

• A. tip of the nose to the base of the neck
• B. the distance from the tip of the nose to the middle of the neck
• C. the distance from the tip of the nose to the tip of the ear lobe
• D. eight to ten inches

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. By the age of three, which age-appropriate food skill can a child typically perform?

• A. Using utensils and a napkin
• B. Spearing food with a fork
• C. Measuring liquids
• D. Displaying proper table manners

Correct answer: B

Rationale: By the age of three, a child typically develops the motor skills needed to spear food with a fork. This is a critical milestone in self-feeding as it shows progress in fine motor coordination. Choice 'A' is incorrect because using utensils and a napkin properly is a skill that may take longer to develop and refine. Choice 'C' is not correct as measuring liquids requires a higher level of motor skills and understanding of quantities that a three-year-old child might not possess. Choice 'D' is also incorrect as the proper display of table manners is a complex skill that is typically learned over a longer period and involves social and cultural norms.

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