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 common comorbidity in patients with Chronic Kidney Disease (CKD) is:

• A. Liver disease
• B. Malnutrition
• C. Acute renal failure
• D. Difficulty breathing

Correct answer: B

Rationale: Malnutrition is a common comorbidity in patients with Chronic Kidney Disease (CKD). This is mainly due to factors such as dietary restrictions, poor appetite, and the body's increased nutritional needs as it struggles to deal with the disease. Liver disease (Choice A) is not typically associated directly with CKD, although both conditions may coexist in some patients. Acute renal failure (Choice C) is not a comorbidity but a severe and potentially lethal progression of CKD. Difficulty breathing (Choice D) is not a comorbidity but can be a symptom of severe kidney disease or other underlying conditions. However, malnutrition is more commonly observed in CKD patients compared to difficulty breathing.

3. Angie is a disoriented client who frequently falls from the bed. As her nurse, which of the following is the best nursing intervention to prevent future falls?

• A. Tell Angie not to get up from bed unassisted
• B. Put the call bell within her reach
• C. Put bedside commode at the bedside to prevent Angie from getting up
• D. Put the bed in the lowest position ever

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.

4. Being in contact with reality and the environment is a function of the:

• A. conscience
• B. ego
• C. id
• D. super ego

Correct answer: B

Rationale: Being in contact with reality and the environment is a function of the ego. The ego is responsible for mediating between the id's basic desires, the superego's idealistic standards, and the real world. The conscience (not listed as a choice) is related to feelings of guilt or moral responsibility. The id represents primal instincts, and the superego represents the internalized ideals and moral standards.

5. Which nutrient is most closely associated with the prevention of neural tube defects in a developing fetus for a woman planning to become pregnant?

• A. Calcium
• B. Folate
• C. Vitamin A
• D. Choline

Correct answer: B

Rationale: The correct answer is folate. Folate, also known as Vitamin B9, is vital for the prevention of neural tube defects in the developing fetus. It is primarily responsible for the creation and repair of DNA, which is essential during rapid growth stages such as pregnancy. While nutrients like calcium, vitamin A, and choline are important for pregnancy, they are not as directly linked to preventing neural tube defects as folate. Calcium is crucial for the baby's bone and teeth development. Vitamin A is essential for vision, immune function, and cellular growth. Choline supports brain development and neural functioning. However, none of these nutrients have the same direct impact on preventing neural tube defects as folate.

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