Nursing Elites

1. A client who is in her second trimester of pregnancy should increase her caloric intake by how many calories during this trimester?

• A. 110 cal/day
• B. 225 cal/day
• C. 340 cal/day
• D. 450 cal/day

Correct answer: C

Rationale: During the second trimester of pregnancy, it is recommended that a client increases their caloric intake by around 340 calories per day to support the growing needs of both the mother and the developing fetus. This additional intake helps ensure the proper nutrition and energy levels required during this crucial stage of pregnancy. Option A (110 cal/day) is too low to meet the increased demands. Option B (225 cal/day) is also below the recommended amount. Option D (450 cal/day) is higher than necessary and could lead to excessive weight gain, which is not ideal during pregnancy.

2. Discharge plans of diabetic clients include injection site rotation. You should emphasize that the space between sites should be:

• A. 6.0 cm.
• B. 5.0 cm.
• C. 2.5 cm.
• D. 4.0 cm.

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.

3. In obtaining a urine specimen for culture and sensitivity on a catheterized patient, the nurse is correct if:

• A. Clamp the catheter for 30 minutes, Alcoholize the tube above the clamp site, Obtain a sterile syringe and draw the
• B. Alcoholize the self sealing port, obtain a sterile syringe and draw the specimen on the self sealing port
• C. Disconnect the drainage bag, obtain a sterile syringe and draw the specimen from the drainage bag
• D. Disconnect the tube, obtain a sterile syringe and draw the specimen from the tube

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. 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. Choices A, B, and C do not typically require TPN. Choice A is managing postoperative pain with IV PCA, choice B is likely to need alternative feeding methods due to dysphagia, and choice C is going home with oxygen for COPD management, which does not directly relate to the need for TPN.

5. The rationales for using a prostaglandin gel for a client prior to the induction of labor is to:

• A. Soften and efface the cervix
• B. Numb cervical pain receptors
• C. Prevent cervical lacerations
• D. Stimulate uterine contractions

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

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