Nursing Elites

1. A client with Crohn's disease is receiving parenteral nutrition. Which of the following interventions should the nurse not include in the care of this client?

• A. Remove the parenteral nutrition solution from the refrigerator 2 hours before infusion.
• B. Remove unused parenteral nutrition after 12 hours of use.
• C. Monitor daily laboratory values and report abnormalities as needed.
• D. Monitor the flow rate of the parenteral nutrition carefully and adjust it if necessary.

Correct answer: B

Rationale: In caring for a client receiving parenteral nutrition, it is important to follow proper guidelines to ensure safety and effectiveness. Unused parenteral nutrition should be removed after 24 hours, not 12 hours, to prevent contamination and reduce the risk of infection. Option A is correct as it ensures the solution is at room temperature before infusion. Option C is essential for monitoring the client's response to parenteral nutrition. Option D is important to maintain the correct flow rate and adjust it as needed. Therefore, option B is the incorrect choice among the options provided.

2. Which team member works with the client to evaluate the need for special feeding devices and then teaches the client how to use the device?

• A. dietitian
• B. speech-language pathologist
• C. dietetic technician
• D. occupational therapist

Correct answer: D

Rationale: An occupational therapist is the team member who works with the client to evaluate the need for special feeding devices and teaches the client how to use them. Occupational therapists specialize in helping individuals with physical or cognitive impairments to perform daily activities. In this scenario, the need for special feeding devices may be due to impaired motor function or disability, making the occupational therapist the correct choice. The other options, dietitian, speech-language pathologist, and dietetic technician, do not typically specialize in evaluating the need for feeding devices or teaching clients how to use them.

3. Which set of guidelines is intended to assess nutrient adequacy or plan intake of a population group, not individuals?

• A. RDA
• B. EAR
• C. DRA
• D. UL

Correct answer: B

Rationale: The Estimated Average Requirement (EAR) is the correct choice because it is specifically designed to assess the nutrient adequacy of population groups, not individuals. The Recommended Dietary Allowance (RDA) (choice A) is the average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%-98%) healthy individuals in a particular life stage and gender group. The Dietary Reference Intake (DRI) (choice C) includes the EAR, RDA, Adequate Intake (AI), and UL, making it a broader set of nutrient reference values. The Tolerable Upper Intake Level (UL) (choice D) is the highest average daily nutrient intake level that is likely to pose no risk of adverse health effects to almost all individuals in the general population.

4. Plant stanols and sterols help to lower LDL cholesterol and are often added to which food product?

• A. margarine
• B. milk
• C. cereal
• D. yogurt

Correct answer: A

Rationale: Plant stanols and sterols are commonly added to margarine to help lower LDL cholesterol levels. Margarine acts as a vehicle for these compounds, making it easier for individuals to incorporate them into their daily diet. While milk, cereal, and yogurt are healthy food options, they are not typically enriched with plant stanols and sterols for cholesterol-lowering purposes, making them less likely candidates as the correct answer.

5. Which food item interferes with the effectiveness of warfarin?

• A. Cauliflower
• B. Zucchini
• C. Green beans
• D. Broccoli

Correct answer: D

Rationale: Broccoli is high in vitamin K, which can affect the effectiveness of warfarin. Warfarin is an anticoagulant medication that functions by reducing the activity of vitamin K in the body. When one consumes broccoli, which is rich in vitamin K, it could counteract the anticoagulant effect of warfarin, thereby interfering with its effectiveness. On the other hand, cauliflower, zucchini, and green beans do not have significant levels of vitamin K and hence, are not known to impact the effectiveness of warfarin.

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