Nursing Elites

1. The PEM in which children ages 18-24 months display edema of the extremities, torso, and face, fatty liver, sparse yellow hair, and receive adequate kilocalories but not enough high-quality proteins is called?

• A. Marasmus
• B. Kwashiorkor
• C. Anemia
• D. Noma

Correct answer: B

Rationale: Kwashiorkor is a form of severe malnutrition characterized by edema, fatty liver, and other symptoms, typically resulting from inadequate protein intake despite adequate calorie intake.

2. A nurse is assessing a client who reports muscle spasms in his calves and tingling in his hands. The client indicates consuming a low intake of milk products and green leafy vegetables. The nurse should identify that the client's findings indicate a deficiency in which of the following sources of nutrition?

• A. Iron
• B. Omega-3 fatty acids
• C. Vitamin C
• D. Calcium

Correct answer: D

Rationale: The correct answer is D, Calcium. Muscle spasms and tingling suggest a calcium deficiency, which is commonly associated with a low intake of milk products and green leafy vegetables. Iron (choice A) deficiency typically presents with fatigue and weakness, not muscle spasms and tingling. Omega-3 fatty acids (choice B) are essential for brain function and heart health, but their deficiency does not manifest as muscle spasms and tingling. Vitamin C (choice C) deficiency leads to scurvy with symptoms like bleeding gums and bruising, not muscle spasms and tingling.

3. A patient with renal insufficiency should limit the intake of which of the following nutrients?

• A. Phosphorus
• B. Potassium
• C. Sodium
• D. Calcium

Correct answer: A

Rationale: In patients with renal insufficiency, impaired kidney function can lead to difficulty in excreting phosphorus. High phosphorus levels can result in further complications such as bone and heart problems. Therefore, limiting the intake of phosphorus is crucial. Potassium and sodium restrictions may also be necessary in renal insufficiency, but the primary concern related to nutrients is phosphorus in this scenario. Calcium, while important for bone health, does not typically need to be restricted in renal insufficiency unless there is a specific medical reason to do so.

4. A client receiving total parenteral nutrition (TPN is awaiting the next container. What fluid should the nurse infuse in the interim?

• A. Dextrose 5% in water
• B. 0.9% sodium chloride
• C. Dextrose 10% in water
• D. Lactated Ringer's solution

Correct answer: B

Rationale: The correct answer is 0.9% sodium chloride. When a client receiving TPN is awaiting the next container, infusing 0.9% sodium chloride is the appropriate choice to maintain fluid and electrolyte balance. Dextrose solutions are not recommended as they do not provide sufficient nutrition. Lactated Ringer's solution contains electrolytes but lacks essential nutrients found in TPN, making it an inadequate choice during the delay in TPN delivery.

5. In conducting a cleansing enema, how does the nurse position the client?

• A. Right lateral position
• B. Left lateral position
• C. Right Sim's position
• D. Left Sim's position

Correct answer: B

Rationale: In preparing a patient for a cleansing enema, the nurse typically positions the patient in the left lateral position. This position allows for the best flow of the solution due to the anatomical configuration of the colon. The right lateral position, right Sim's position, and left Sim's position are not typically used for this procedure. The rationale provided initially is incorrect as it pertains to lung expansion and postural drainage, which are not relevant to a cleansing enema procedure.

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