Nursing Elites

1. A client receiving total parenteral nutrition (TPN is awaiting the next container. What fluid should the nurse infuse in the interim?

• A. Dextrose 5% in water
• B. 0.9% sodium chloride
• C. Dextrose 10% in water
• D. Lactated Ringer's solution

Correct answer: B

Rationale: The correct answer is 0.9% sodium chloride. When a client receiving TPN is awaiting the next container, infusing 0.9% sodium chloride is the appropriate choice to maintain fluid and electrolyte balance. Dextrose solutions are not recommended as they do not provide sufficient nutrition. Lactated Ringer's solution contains electrolytes but lacks essential nutrients found in TPN, making it an inadequate choice during the delay in TPN delivery.

2. What is the most likely complication for a client receiving TPN who suddenly develops tremors, dizziness, and diaphoresis?

• A. Fluid volume overload
• B. Sepsis
• C. Hyperglycemia
• D. Hypoglycemia

Correct answer: D

Rationale: The correct answer is D, Hypoglycemia. When a client receiving TPN suddenly develops tremors, dizziness, and diaphoresis, it is indicative of hypoglycemia. TPN provides a high concentration of glucose, and if it is abruptly stopped or the infusion rate is reduced, it can lead to hypoglycemia. Choices A, B, and C are incorrect as they do not directly correlate with the symptoms described in the scenario. Fluid volume overload typically presents with edema and hypertension, sepsis with fever and increased heart rate, and hyperglycemia with polyuria, polydipsia, and blurred vision.

3. Weight loss therapies that rely on juicing typically provide increased fiber, vitamins, and minerals. As an added incentive, juices contain a lower concentration of sugar than the whole fruit. Are these statements true or false?

• A. Both statements are true
• B. Both statements are false
• C. The first statement is true; the second is false
• D. The first statement is false; the second is true

Correct answer: B

Rationale: The correct answer is both statements are false. The process of juicing often extracts the liquid components of fruits and vegetables, leaving behind the fiber-rich pulp. Therefore, juicing does not typically provide increased fiber. Additionally, juices can contain a higher concentration of sugar than whole fruits because the fiber, which helps to slow down the absorption of sugar, has been removed. This can lead to a spike in blood sugar levels after consumption. The other options are incorrect because they contain at least one false statement.

4. By force of law, therefore, the PRC-Board of Nursing released Resolution No. 14 Series of 1999 entitled: "Adoption of a Nursing Specialty Certification Program and Creation of Nursing Specialty Certification Council." This rule-making power is called:

• A. Quasi-Judicial Power
• B. Regulatory Power
• C. Quasi-Legislative Power
• D. Executive/Promulgating Power

Correct answer: B

Rationale: The correct answer is B: Regulatory Power. Regulatory power involves the authority to create rules and regulations that govern a specific area. In this case, the PRC-Board of Nursing's release of Resolution No. 14 Series of 1999 for the Nursing Specialty Certification Program falls under regulatory power as it establishes guidelines and standards for nursing specialty certification. Choices A, C, and D are incorrect. Quasi-judicial power involves making decisions on rights and obligations, quasi-legislative power involves creating regulations with the force of law, and executive/promulgating power involves enforcing and implementing laws and regulations.

5. A nurse is preparing to administer a gavage feeding via a nasogastric tube to a preterm newborn who is receiving supplemental oxygen. Which of the following actions should the nurse take?

• A. Stabilize the tube with tape to the newborn’s cheek.
• B. Remove supplemental oxygen during the feeding.
• C. Measure the stomach aspirate prior to the feeding.
• D. Place the newborn on their left side for 30 minutes after the feeding.

Correct answer: C

Rationale: Measuring the stomach aspirate prior to the feeding is crucial to ensure the correct placement and function of the nasogastric tube. This step helps prevent complications such as aspiration or improper feeding. Choice A is incorrect as stabilizing the tube with tape to the newborn’s cheek can cause discomfort and skin irritation. Choice B is incorrect because removing supplemental oxygen during the feeding may compromise the newborn's respiratory status. Choice D is incorrect because placing the newborn on their left side for 30 minutes after the feeding is not a standard practice and is unnecessary for administering gavage feeding.

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