Nursing Elites

1. Which of the following nutrients provide energy?(Select ONE that does not apply.)

• A. Carbohydrates
• B. Fats
• C. Protein
• D. Water

Correct answer: D

Rationale: Carbohydrates, fats, and proteins are the three macronutrients that provide energy (calories) to the body. Carbohydrates are the body's primary source of energy, fats act as a secondary source when carbohydrate energy is exhausted, and proteins are used for energy when carbohydrate and fat sources are low. Choice D, Water, is essential for the body's functions, but it does not provide energy.

2. The nurse is working with a patient who recently had a stroke. The patient frequently chokes and coughs when eating and is having difficulty feeding herself. What is the best way to ensure adequate nutrition?

• A. to have an aide feed her at each meal
• B. to ask a family member to assist during meals
• C. to provide tube feedings for the patient
• D. to initiate TPN for the patient

Correct answer: C

Rationale: The best way to ensure adequate nutrition for a stroke patient who frequently chokes and coughs when eating and has difficulty feeding herself is to provide tube feedings. Tube feedings are a safe and effective method to deliver nutrition directly to the stomach or intestines, bypassing the swallowing mechanism, reducing the risk of aspiration. Having an aide feed her each meal (choice A) may not address the underlying issue of swallowing difficulty and aspiration risk. Asking a family member to be present at each meal (choice B) does not provide a definitive solution to the patient's nutritional needs. Placing the patient on total parenteral nutrition (TPN) (choice D) is a more invasive and typically reserved for patients who cannot tolerate enteral feedings or have non-functional gastrointestinal tracts.

3. A nurse is caring for a client with a thiamine deficiency. Which assessment findings will the nurse expect?

• A. Tachycardia, muscle weakness, and lack of coordination
• B. Swollen lips, cracks in the corners of the mouth, and glossitis
• C. Neuropsychiatric symptoms of delusions and hallucinations
• D. Scaly rash on arms, dementia, and diarrhea

Correct answer: A

Rationale: Thiamine deficiency, also known as Vitamin B1 deficiency, can present with various symptoms. Tachycardia, muscle weakness, and lack of coordination are classic signs of thiamine deficiency due to its role in energy metabolism. Swollen lips, cracks in the corners of the mouth, and glossitis are more indicative of a deficiency in riboflavin (Vitamin B2). Neuropsychiatric symptoms of delusions and hallucinations are characteristic of niacin (Vitamin B3) deficiency. A scaly rash on the arms, dementia, and diarrhea are not typically associated with thiamine deficiency. Therefore, the correct assessment findings for a client with thiamine deficiency are tachycardia, muscle weakness, and lack of coordination.

4. Which of the following amino acids are considered indispensable?

• A. Lysine
• B. Methionine
• C. Tryptophan
• D. Valine

Correct answer: A

Rationale: The correct answer is A: Lysine. Indispensable amino acids are those that the body cannot synthesize and must be obtained from the diet. Lysine, methionine, and tryptophan are all examples of indispensable amino acids. However, the question specifically asked for 3 out of the 9 indispensable amino acids, making 'Lysine' the correct choice. Choices B, C, and D are also indispensable amino acids but are not the focus of the question.

5. You are to apply a transdermal patch of nitoglycerin to your client. The following are important guidelines to observe EXCEPT:

• A. Apply to hairless clean area of the skin not subject to much wrinkling
• B. Patches may be applied to distal part of the extremities like forearm
• C. Change application and site regularly to prevent irritation of the skin
• D. Wear gloves to avoid any medication on your hand

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.

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