Nursing Elites

1. A nurse is caring for four clients. The nurse should plan to administer total parenteral nutrition for which of the following clients?

• A. A client who is postoperative following a laminectomy and is receiving IV PCA
• B. A client who has dysphagia and does not recognize his family
• C. A client who has COPD and is going home with oxygen
• D. A client who has colon cancer and will undergo a hemicolectomy

Correct answer: D

Rationale: Total parenteral nutrition (TPN) is essential for clients undergoing significant surgical procedures like a hemicolectomy to ensure they receive adequate nutrition when oral intake is not possible.

2. A nurse is planning care for a client who reports increasing difficulty swallowing food. Which of the following interventions should the nurse plan to take?

• A. Turn on the client’s television during meals.
• B. Place the client into a semi-reclining position for meals.
• C. Encourage the client to rest prior to mealtimes.
• D. Encourage the client to use a straw when drinking liquids.

Correct answer: C

Rationale: Encouraging the client to rest prior to mealtimes can help reduce fatigue and improve the ability to swallow.

3. A client is prescribed a 1500 calorie diet. Thirty percent of the calories are to be derived from fat. How many grams of fat should the nurse tell the client to consume per day? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

• A. 21
• B. 49
• C. 60
• D. 50

Correct answer: D

Rationale: To calculate the grams of fat: 1500 calories x 30% = 450 calories from fat. Since 1 gram of fat = 9 calories, 450 / 9 = 50 grams of fat.

4. A nurse is caring for a client who reports she is having difficulty losing weight. Which of the following responses by the nurse is appropriate?

• A. Eat small portions of the high-calorie foods first.
• B. Set a goal and you will be able to attain it.
• C. It is helpful to self-monitor your eating.
• D. Taste food while cooking to help curb your appetite.

Correct answer: C

Rationale: Self-monitoring dietary intake is an evidence-based strategy that enhances awareness and accountability, making it an effective approach for weight management.

5. A nurse is providing anticipatory guidance to a client who has Phenylketonuria (PKU) and is planning a pregnancy. Which of the following information should the nurse include in the discussion?

• A. Diet sodas should not be consumed more than two or three times per week.
• B. Serum bilirubin should be monitored one or two times per month during pregnancy
• C. Breastfeeding will prevent your baby from developing PKU.
• D. A low-protein diet should be followed for three months prior to conception.

Correct answer: D

Rationale: A low-protein diet helps manage PKU by reducing phenylalanine levels, which is crucial for maternal and fetal health.

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