Nursing Elites

1. A nurse is caring for a client with hepatic encephalopathy. Which food selection indicates an understanding of dietary teaching?

• A. Cottage cheese
• B. Tuna salad
• C. Rice with black beans
• D. Three-egg omelet

Correct answer: C

Rationale: The correct answer is C: 'Rice with black beans.' Clients with hepatic encephalopathy should limit animal proteins due to their high ammonia content, which can exacerbate symptoms. Plant-based proteins like beans are preferred as they help reduce ammonia levels. Choices A, B, and D contain animal proteins that are not ideal for clients with hepatic encephalopathy.

2. A nurse is caring for a client with a stage 2 pressure ulcer. Define the characteristics of the ulcer.

• A. Intact skin with nonblanchable redness (Stage 1)
• B. Full-thickness tissue loss with subQ damage (Stage 3)
• C. Partial-thickness skin loss involving the epidermis and dermis
• D. Full-thickness tissue loss with damage to muscle or bone (Stage 4)

Correct answer: C

Rationale: The correct answer is C. Stage 2 ulcers involve partial-thickness skin loss with visible and superficial damage, which may appear as an abrasion, blister, or shallow crater. Choice A describes a Stage 1 pressure ulcer characterized by intact skin with nonblanchable redness. Choice B describes a Stage 3 pressure ulcer with full-thickness tissue loss and damage to the subcutaneous tissue. Choice D is indicative of a Stage 4 pressure ulcer, involving full-thickness tissue loss with damage extending to muscle or bone.

3. A healthcare provider is discussing recommendations for daily nutrient intake during pregnancy with a client who is at 10 weeks of gestation. For which of the following nutrients should the healthcare provider instruct the client to increase intake during pregnancy?

• A. Vitamin E
• B. Vitamin D
• C. Fiber
• D. Calcium

Correct answer: D

Rationale: The correct answer is D: Calcium. During pregnancy, it is essential to increase calcium intake as it is crucial for fetal bone development and to prevent maternal bone loss. Adequate calcium supports the increased needs of both the mother and the developing baby. Vitamin E, Vitamin D, and fiber are also important nutrients, but the specific nutrient that needs to be increased during pregnancy for bone development is calcium. Vitamin E is an antioxidant that plays a role in protecting cells from damage, Vitamin D helps with calcium absorption and bone health, and fiber is important for digestive health but does not specifically need to be increased during pregnancy for bone development.

4. A client is being educated by a nurse on nutritional intake. Which of the following should the nurse include in the teaching?

• A. Carbohydrates should be at least 45% of your caloric intake
• B. Protein should be at least 55% of your caloric intake
• C. Carbohydrates should be at least 30% of your caloric intake
• D. Protein should be at least 60% of your caloric intake

Correct answer: A

Rationale: Carbohydrates should make up 45-65% of daily caloric intake as they are the body’s main source of energy. This aligns with general dietary recommendations. Choice B is incorrect as protein should typically make up about 10-35% of daily caloric intake, not 55%. Choice C is also incorrect, as carbohydrates should ideally be between 45-65%, not 30%. Choice D is incorrect because protein should generally account for around 10-35% of total caloric intake, not 60%.

5. A nurse is in an acute care facility, caring for a client who is postop following abdominal surgery. Which behavior should the nurse identify as increasing the client's risk for constipation?

• A. Increased fiber intake
• B. Suppression of the urge to defecate
• C. Ambulation twice a day
• D. Daily laxative use

Correct answer: B

Rationale: The correct answer is B: 'Suppression of the urge to defecate.' Suppressing the urge to defecate can lead to constipation, especially in postoperative clients. It is essential to encourage clients to respond to the urge to defecate to prevent constipation. Increased fiber intake (Choice A) is beneficial for preventing constipation. Ambulation (Choice C) helps promote bowel motility and can reduce the risk of constipation. Daily laxative use (Choice D) may contribute to laxative dependence but is not the behavior most directly associated with increasing the risk of constipation in this scenario.

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