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. How many calories are contained in a food that has 15 grams of carbohydrates, 4 grams of protein, and 10 grams of fat?

• A. 106
• B. 124
• C. 166
• D. 202

Correct answer: C

Rationale: To calculate the total calories in a food item, you can use the following conversions: every 1 gram of carbohydrate provides 4 calories, 1 gram of protein provides 4 calories, and 1 gram of fat provides 9 calories. Therefore, for this food item, multiply 15 grams of carbohydrates by 4 calories/gram, 4 grams of protein by 4 calories/gram, and 10 grams of fat by 9 calories/gram. The calculation would be (15 * 4) + (4 * 4) + (10 * 9) = 60 + 16 + 90 = 166 calories. Choice A (106) is incorrect because it does not consider the calories from fat. Choice B (124) is incorrect as it underestimates the calories by not including all macronutrients. Choice D (202) is incorrect as it overestimates the calories by adding up the values incorrectly.

3. The healthcare professional in the dialysis unit understands that patients may experience various complications during hemodialysis. What describes a common complication during hemodialysis?

• A. confusion
• B. profuse sweating
• C. hypertension
• D. leg cramps

Correct answer: D

Rationale: Leg cramps are a common complication during hemodialysis due to shifts in fluid and electrolyte levels that occur during the treatment. Confusion (choice A) is not a common complication specifically related to hemodialysis. Profuse sweating (choice B) is not typically associated with hemodialysis complications. Hypertension (choice C) might be a pre-existing condition in some patients but is not a direct common complication of hemodialysis.

4. What happens when Mrs. Guevarra, a nurse, delegates aspects of the client's care to the nurse-aide, an unlicensed staff member?

• A. Mrs. Guevarra makes the assignment to instruct the staff member
• B. Mrs. Guevarra is assigning the responsibility to the aide but not the accountability for those tasks
• C. Mrs. Guevarra does not need to directly supervise or evaluate the aide
• D. Mrs. Guevarra must know how to perform the task being delegated

Correct answer: C

Rationale: The correct answer is C. While it is true that Mrs. Guevarra is delegating tasks to the nurse-aide, she does not necessarily have to directly supervise or evaluate the aide. She still retains the overall accountability for the care of the client, but direct supervision of the aide is not a requirement for delegation. Choice A is incorrect because the primary purpose of delegation is not instruction. Choice B is also incorrect because although Mrs. Guevarra is delegating tasks, she still retains accountability for those tasks. Finally, choice D is incorrect because the ability to perform the task being delegated is not a requirement for the delegator; the delegatee should have the necessary skills and knowledge to perform the delegated tasks.

5. Which of the following body processes is not dependent upon the presence of calcium in the body fluids?

• A. blood clotting
• B. transport of oxygen in the blood
• C. muscle contractions
• D. transmission of nerve impulses

Correct answer: B

Rationale: The transport of oxygen in the blood is carried out by hemoglobin, which does not require calcium; instead, calcium is essential for blood clotting, muscle contraction, and nerve transmission.

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