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 reviewing blood glucose values for a client who is at risk for Diabetes Mellitus. Which of the following findings should the nurse report to the provider?

• A. 2-hour glucose tolerance test level 150 mg/dL
• B. Fasting blood glucose 70 mg/dL
• C. Glycosylated hemoglobin 5%
• D. Casual blood glucose 90 mg/dL

Correct answer: A

Rationale: The correct answer is A. A 2-hour glucose tolerance test level of 150 mg/dL is above the normal range and should be reported to the provider as it indicates impaired glucose tolerance. Choice B (Fasting blood glucose 70 mg/dL) is within the normal range. Choice C (Glycosylated hemoglobin 5%) is also within the normal range. Choice D (Casual blood glucose 90 mg/dL) is within the normal range and does not indicate impaired glucose tolerance.

3. In a patient with osteoporosis, which mineral is essential to prevent further bone loss?

• A. Iron
• B. Phosphorus
• C. Magnesium
• D. Calcium

Correct answer: D

Rationale: Calcium is crucial in preventing bone loss in patients with osteoporosis.

4. Which metabolic disease is characterized by poor healing, severe forms of periodontal disease, necrosis, xerostomia, and candidiasis?

• A. Hypopituitarism
• B. Diabetes mellitus
• C. Hyperthyroidism
• D. Renal disease

Correct answer: B

Rationale: Diabetes mellitus is the correct answer. It is associated with poor wound healing, severe periodontal disease, tissue necrosis, dry mouth (xerostomia), and an increased susceptibility to oral infections like candidiasis. Hypopituitarism, hyperthyroidism, and renal disease are not typically linked to the specific oral manifestations described in the question.

5. What is the priority nursing goal for an adolescent with anorexia nervosa?

• A. Encourage effective coping skills
• B. Restore normal eating habits
• C. Stop weight loss or restore weight
• D. Promote realistic self-image

Correct answer: C

Rationale: The priority nursing goal for an adolescent with anorexia nervosa is to stop weight loss or restore weight. This is crucial in addressing the immediate health risks associated with anorexia nervosa, such as malnutrition, organ damage, and potential life-threatening complications. While encouraging effective coping skills, restoring normal eating habits, and promoting a realistic self-image are important aspects of treatment, stopping weight loss or restoring weight takes precedence due to the severe physical consequences of anorexia nervosa.

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