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 discharge teaching for a client who has acute pancreatitis and has a prescription for fat-soluble vitamin supplements. The nurse should instruct the client to take a supplement for which of the following?

• A. Vitamin A
• B. Vitamin B1
• C. Vitamin C
• D. Vitamin B12

Correct answer: A

Rationale: In acute pancreatitis, malabsorption of fat-soluble vitamins can occur due to pancreatic enzyme insufficiency. Vitamin A is a fat-soluble vitamin that may need supplementation in this case. Vitamin B1 (thiamine), Vitamin C, and Vitamin B12 are water-soluble vitamins and are not typically affected by pancreatic enzyme insufficiency in acute pancreatitis. Therefore, the correct supplement for the client with acute pancreatitis is Vitamin A.

3. Does the hypothalamus control the feeling of hunger and satiety, and are fats the best nutrient in creating the feeling of satiety?

• A. TRUE
• B. FALSE
• C.
• D.

Correct answer: A

Rationale: Yes, the hypothalamus plays a crucial role in regulating hunger and satiety. Fats are indeed known to be highly satiating nutrients, helping to create a feeling of fullness and satisfaction after a meal. Therefore, both statements are true. Choice B is incorrect because fats are indeed effective in promoting satiety.

4. Which of the following should a patient with a history of chronic pancreatitis avoid?

• A. Low-fat dairy
• B. Lean meats
• C. High-fiber vegetables
• D. Alcohol

Correct answer: D

Rationale: The correct answer is D: Alcohol. Alcohol consumption can exacerbate chronic pancreatitis due to its detrimental effects on the pancreas. Conversely, options A, B, and C: Low-fat dairy, Lean meats, and High-fiber vegetables, are generally recommended for patients with chronic pancreatitis. These dietary options are easier on the pancreas and less likely to provoke symptoms. Therefore, they are incorrect choices in this context.

5. The healthcare professional in the dialysis unit understands that patients may experience various complications during hemodialysis. What describes a common complication during hemodialysis?

• A. confusion
• B. profuse sweating
• C. hypertension
• D. leg cramps

Correct answer: D

Rationale: Leg cramps are a common complication during hemodialysis due to shifts in fluid and electrolyte levels that occur during the treatment. Confusion (choice A) is not a common complication specifically related to hemodialysis. Profuse sweating (choice B) is not typically associated with hemodialysis complications. Hypertension (choice C) might be a pre-existing condition in some patients but is not a direct common complication of hemodialysis.

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