Nursing Elites

1. During the later stages of chronic kidney disease, what is the recommended protein intake in grams per kilogram of body weight per day?

• A. 0.6 to 0.75
• B. 1.2 to 1.55
• C. 1.0 to 1.2
• D. 0.8 to 1.0

Correct answer: A

Rationale: In the later stages of chronic kidney disease, the recommended protein intake is typically restricted to 0.6 to 0.75 grams per kilogram of body weight per day. This lower protein intake helps reduce the workload on the kidneys, as excessive protein can be challenging for the kidneys to process. Choice B (1.2 to 1.55) is incorrect as it suggests a higher protein intake, which is not recommended for individuals with advanced kidney disease. Choices C (1.0 to 1.2) and D (0.8 to 1.0) also advocate for protein intakes higher than what is typically advised for individuals in later stages of chronic kidney disease.

2. While the client has a pulse oximeter on his fingertip, you notice that sunlight is shining on the area where the oximeter is. Your action will be to:

• A. Set and turn on the alarm of the oximeter
• B. Do nothing since there is no identified problem
• C. Cover the fingertip sensor with a towel or bedsheet
• D. Change the location of the sensor every four hours

Correct answer: B

Rationale: In this scenario, the correct action is to do nothing since there is no identified problem with the sunlight shining on the area where the oximeter is placed. The functionality of the oximeter is not affected by sunlight, so covering it or changing its location unnecessarily could disrupt the monitoring process. Setting the alarm or changing the sensor location every four hours is not indicated in this situation and may lead to unnecessary interventions. It's essential to assess the situation carefully and intervene only when necessary, ensuring that care provided is appropriate and effective.

3. 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.

4. When observing a return demonstration of a colostomy irrigation, you know that more teaching is required if pt:

• A. Lubricates the tip of the catheter prior to inserting into the stoma
• B. Hangs the irrigating bag on the bathroom door cloth hook during fluid insertion
• C. Discontinues the insertion of fluid after only 500 ml of fluid has been instilled
• D. Clamps of the flow of fluid when felling uncomfortable

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. Which breakfast item should be recommended for a vegan adolescent to combine protein?

• A. Bagel with cream cheese
• B. Wheat toast with jelly
• C. Oatmeal pancakes with peanut butter
• D. Eggs with tofu bacon

Correct answer: C

Rationale: Oatmeal pancakes with peanut butter provide a protein combination suitable for a vegan diet.

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