Nursing Elites

1. 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.

2. A nurse is providing nutritional education to a client who is obese. The nurse should include in the information that which of the following gastrointestinal disorders is commonly associated with obesity?

• A. Peptic ulcer disease
• B. Gastroesophageal reflux disease
• C. Celiac disease
• D. Crohn’s disease

Correct answer: B

Rationale: Gastroesophageal reflux disease (GERD) is commonly associated with obesity due to increased abdominal pressure and other factors. Peptic ulcer disease (Choice A) is not commonly associated with obesity. Celiac disease (Choice C) is an autoimmune disorder triggered by gluten consumption and is not directly linked to obesity. Crohn’s disease (Choice D) is a type of inflammatory bowel disease and is not specifically associated with obesity.

3. Which food provides a 1-ounce serving of grains for a preschool child?

• A. 1 cup of ready-to-eat cereal flakes
• B. 1⁄2 slice of whole wheat bread
• C. 1⁄2 of a 6-inch flour tortilla
• D. 1 cup of cooked rice

Correct answer: A

Rationale: The correct answer is A: 1 cup of ready-to-eat cereal flakes. For a preschool child, 1 cup of ready-to-eat cereal flakes provides a 1-ounce serving of grains, meeting the requirement. Choice B, 1⁄2 slice of whole wheat bread, is not the correct answer as it does not constitute a 1-ounce serving of grains. Similarly, choice C, 1⁄2 of a 6-inch flour tortilla, does not offer a 1-ounce serving of grains. Choice D, 1 cup of cooked rice, also does not provide a 1-ounce serving of grains for a preschool child, making it an incorrect choice.

4. A nurse is providing teaching to a client who has type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?

• A. Albumin in my urine is an indication of normal kidney function.
• B. I will keep my HbA1c at five percent.
• C. I will have ketones in my urine if my blood glucose is maintained at 190 milligrams per deciliter.
• D. I will keep my blood glucose levels between 200 and 212 milligrams per deciliter.

Correct answer: B

Rationale: The correct answer is B. Maintaining an HbA1c level of 5 percent indicates good long-term blood glucose control and understanding of diabetes management. Choice A is incorrect because the presence of albumin in the urine (albuminuria) is actually an indication of kidney damage in diabetes. Choice C is incorrect as ketones in the urine are a sign of inadequate insulin and can occur when blood glucose levels are high, not at a specific level like 190 mg/dL. Choice D is also incorrect as the client should aim to keep blood glucose levels within a tighter range for better control, typically between 80-130 mg/dL before meals and less than 180 mg/dL after meals.

5. The correct temperature to store vaccines in a refrigerator is:

• A. between -4 deg C and +8 deg C
• B. between 2 deg C and +8 deg C
• C. between -8 deg C and 0 deg C
• D. between -8 deg C and +4 deg C

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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