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. A nurse is assessing a client who has malnutrition. Which of the following findings should the nurse expect?

• A. Increased vital capacity
• B. Dry skin
• C. Heat intolerance
• D. Decreased mental status

Correct answer: D

Rationale: Malnutrition can lead to a variety of physical and mental symptoms. One common manifestation of malnutrition is a decreased mental status, which includes confusion, lethargy, and cognitive impairment. Dry skin is a typical finding in malnutrition due to the lack of essential nutrients needed for skin health. Heat intolerance is not a direct consequence of malnutrition. While malnutrition can affect respiratory function, it typically leads to decreased vital capacity rather than increased. Therefore, the correct answer is decreased mental status.

3. Which nutrient deficiency are people who regularly take prescription drugs such as steroids and diuretics at risk for?

• A. Potassium
• B. Selenium
• C. Iodine
• D. Chloride

Correct answer: A

Rationale: Regular intake of prescription drugs like steroids and diuretics can lead to the loss of potassium in the body, causing a condition known as hypokalemia. Therefore, people on these medications require careful monitoring and often need potassium supplementation to prevent this deficiency. The other options, selenium, iodine, and chloride, are incorrect because there is no specific link between their deficiency and the regular use of steroids and diuretics.

4. You are caring for Conrad who has a brain tumor and increased Intracranial Pressure (ICP). Which intervention should you include in your plan to reduce ICP?

• A. Administer bowel softener
• B. Position Conrad with his head turned toward the side of the tumor
• C. Provide sensory stimulation
• D. Encourage coughing and deep breathing

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.

5. The purpose of chest percussion and vibration is to loosen secretions in the lungs. The difference between the procedures is:

• A. Percussion uses only one hand, while vibration uses both hands
• B. Percussion delivers cushioned blows to the chest with cupped palms, while vibration gently shakes secretions loose
• C. In both percussion and vibration, the hands are not on top of each other, and hand action is not in tune with the client's breath
• D. Percussion slaps the chest to loosen secretions, while vibration shakes the secretions along with the inhalation

Correct answer: D

Rationale: Chest percussion involves the use of rhythmic tapping to dislodge mucus from the lungs, facilitating its movement toward the larger airways where it can be expelled. This technique is particularly important in conditions where mucus retention is a significant risk factor for infection. The key difference between chest percussion and vibration is that percussion involves slapping the chest to loosen secretions, while vibration involves shaking the secretions along with the inhalation, aiding in moving the loosened secretions upwards for easier removal. Choices A, B, and C do not accurately describe the main difference between chest percussion and vibration, making them incorrect.

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