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 of the following nutrients does not provide energy?

• A. Proteins
• B. Carbohydrates
• C. Fats
• D. Vitamins

Correct answer: D

Rationale: Proteins, carbohydrates, and fats are macronutrients that provide energy in the form of calories when consumed and metabolized by the body. Each gram of protein or carbohydrate provides about 4 calories, and each gram of fat provides about 9 calories. On the other hand, vitamins do not provide energy or calories. They are micronutrients that are essential for various biochemical and physiological processes in the body, including the metabolism of macronutrients. However, they do not contribute directly to the energy supply. Therefore, the correct answer is 'D: Vitamins'. Choices A, B, and C (Proteins, Carbohydrates, and Fats) are incorrect because they are macronutrients that do provide energy/calories when metabolized.

3. An emerging technique in screening for Breast Cancer in developing countries like the Philippines is:

• A. Mammography once a year starting at the age of 50
• B. Clinical BSE Once a year
• C. BSE Once a month
• D. Pap smear starting at the age of 18 or earlier if sexually active

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.

4. Which hormone is produced in fat tissue and helps regulate body fat by suppressing appetite?

• A. glucagon
• B. ghrelin
• C. leptin
• D. insulin

Correct answer: C

Rationale: The correct answer is C, leptin. Leptin is a hormone produced by fat cells that helps regulate energy balance by suppressing hunger, thus aiding in the regulation of body fat. Glucagon (choice A) is a hormone that raises blood glucose levels, ghrelin (choice B) stimulates appetite, and insulin (choice D) regulates blood sugar levels and promotes glucose uptake.

5. 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.

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