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 patient with renal insufficiency should limit the intake of which of the following nutrients?

• A. Phosphorus
• B. Potassium
• C. Sodium
• D. Calcium

Correct answer: A

Rationale: In patients with renal insufficiency, impaired kidney function can lead to difficulty in excreting phosphorus. High phosphorus levels can result in further complications such as bone and heart problems. Therefore, limiting the intake of phosphorus is crucial. Potassium and sodium restrictions may also be necessary in renal insufficiency, but the primary concern related to nutrients is phosphorus in this scenario. Calcium, while important for bone health, does not typically need to be restricted in renal insufficiency unless there is a specific medical reason to do so.

3. You are taking care of critically ill client and the doctor in charge calls to order a DNR (do not resuscitate) for the client. Which of the following is the appropriate action when getting DNR order over the phone?

• A. Have the registered nurse, family spokesperson, nurse supervisor and doctor sign
• B. Have 2 nurse validate the phone order, both nurses sign the order and the doctor should sign his order within 24
• C. Have the registered nurse, family and doctor sign the order
• D. Have 1 nurse take the order and sign it and have the doctor sign it within 24 hours

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

4. A client receiving chemotherapy treatments tells the nurse, 'I feel so nauseated after my treatments.' Which of the following instructions should the nurse provide the client?

• A. Eat common foods that are served cold.
• B. Sip fluids slowly throughout the day.
• C. Sit up for 1 hr after eating meals.
• D. All of the Above

Correct answer: D

Rationale: The correct answer is D, 'All of the Above.' Common foods served cold, sipping fluids slowly throughout the day, and sitting up for 1 hr after eating meals can help manage nausea associated with chemotherapy. Eating common foods served cold can be easier on the stomach, sipping fluids slowly can prevent overwhelming the digestive system, and sitting up after meals can aid digestion. Choices A, B, and C all contribute to alleviating nausea and are appropriate instructions for the client.

5. A nurse is planning teaching for the parents of a toddler who follows a vegetarian diet. The nurse should plan to include which of the following foods as the best source of dietary protein for the child?

• A. Soy milk
• B. Peanut butter
• C. Dried beans
• D. Whole grains

Correct answer: C

Rationale: Dried beans are the best source of dietary protein for a toddler following a vegetarian diet. They are rich in protein and other essential nutrients. Soy milk, while a good source of protein, may not provide as much protein density as dried beans. Peanut butter is a good source of protein but may not be as protein-dense as dried beans. Whole grains are not as high in protein content compared to dried beans, making them a less optimal choice for meeting the toddler's protein needs.

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