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. You will do nasopharyngeal suctioning on Mr. Abad. Your guide for the length of insertion of the tubing for an adult would be:

• A. tip of the nose to the base of the neck
• B. the distance from the tip of the nose to the middle of the neck
• C. the distance from the tip of the nose to the tip of the ear lobe
• D. eight to ten inches

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.

3. Which food has the highest calcium content?

• A. 1 cup of carrot strips
• B. 3 oz of canned salmon
• C. 1 plain baked potato
• D. 1 cup of chopped chicken breast

Correct answer: B

Rationale: The highest source of calcium among the given choices is the 3 oz of canned salmon. This is due to the presence of bones in canned salmon, which are rich in calcium. The other options, including 1 cup of carrot strips, 1 plain baked potato, and 1 cup of chopped chicken breast, do not contain as much calcium due to the nature of their composition and lack of bone content.

4. A patient following a vegetarian diet might be at risk for deficiency in which nutrient?

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

Correct answer: B

Rationale: Vitamin B12 is primarily found in animal products, so vegetarians may need supplementation.

5. Churns chyme and has an environment of pH2; holds 4-6 cups of food:

• A. stomach
• B. pancreas
• C. large intestine
• D. small intestine

Correct answer: A

Rationale: The stomach churns food into chyme and has a highly acidic environment (pH 2) to aid in the digestion of proteins and other nutrients.

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