Nursing Elites

1. What are the potential complications of a patient receiving total parenteral nutrition (TPN)?

• A. Infection and electrolyte imbalance
• B. Hyperglycemia and sepsis
• C. Kidney failure and hypovolemia
• D. Fluid overload and liver damage

Correct answer: A

Rationale: Infection and electrolyte imbalance are common complications of TPN. Infection can occur due to the invasive nature of TPN, which provides a direct route for pathogens. Electrolyte imbalances can arise from the composition of the TPN solution or improper monitoring. Hyperglycemia and sepsis (Choice B) are potential complications but are not as directly associated with TPN as infection and electrolyte imbalance. Kidney failure and hypovolemia (Choice C) are less common complications of TPN. Fluid overload and liver damage (Choice D) are potential complications but are not as frequently observed as infection and electrolyte imbalance.

2. A nurse is reinforcing teaching about using a cane with a client who has left-leg weakness. What instruction should the nurse give?

• A. Use the cane on the weaker side
• B. Advance the cane and the strong leg together
• C. Maintain two points of support on the floor at all times
• D. Advance the cane 30 to 45 cm with each step

Correct answer: C

Rationale: The correct instruction for a client with left-leg weakness using a cane is to maintain two points of support on the floor at all times. This technique provides stability and support while walking. Choice A is incorrect because the cane should be used on the stronger side to support the weaker leg. Choice B is incorrect as advancing the cane and the strong leg together may not provide adequate support and balance. Choice D is incorrect as the distance to advance the cane with each step can vary depending on the individual's needs and abilities.

3. A client who is to undergo an exercise stress test is being taught by a nurse. Which of the following statements by the client indicates an understanding of the teaching?

• A. I should eat a large meal 2 hours before the test
• B. I should avoid drinking water before the test
• C. I should stop taking my blood pressure medication
• D. I should report any chest pain during the test

Correct answer: D

Rationale: The correct answer is D: 'I should report any chest pain during the test.' This statement indicates an understanding of the teaching because reporting chest pain during an exercise stress test is crucial as it may signify cardiac distress. Choices A, B, and C are incorrect. Eating a large meal 2 hours before the test is not recommended as it may affect the results. Avoiding drinking water before the test is also not advisable as staying hydrated is important. Stopping blood pressure medication without medical advice can be dangerous, especially before a stress test.

4. What are the risk factors for stroke, and how can it be prevented?

• A. High cholesterol and hypertension; prevent with regular exercise
• B. Obesity and smoking; prevent with medication and weight loss
• C. Diabetes and alcohol consumption; prevent with regular checkups
• D. Lack of exercise and poor diet; prevent with lifestyle changes

Correct answer: A

Rationale: The correct answer is A. High cholesterol and hypertension are significant risk factors for stroke. Regular exercise is an effective way to prevent stroke by managing these risk factors. Choice B is incorrect as while obesity and smoking are risk factors, preventing stroke through medication and weight loss is not the primary method. Choice C is incorrect as diabetes and alcohol consumption are risk factors, but preventing stroke through regular checkups is not as direct as managing cholesterol and hypertension. Choice D is incorrect as lack of exercise and a poor diet are indeed risk factors, but the prevention of stroke through lifestyle changes needs to specifically address high cholesterol and hypertension.

5. Which of the following interventions is most appropriate for a client with left-leg weakness who is learning to use a cane?

• A. Maintain two points of support on the floor at all times
• B. Use the cane on the weak side of the body
• C. Advance the cane and the strong leg simultaneously
• D. Advance the cane 30 to 45 cm (12-18 in) with each step

Correct answer: A

Rationale: The most appropriate intervention for a client with left-leg weakness learning to use a cane is to maintain two points of support on the floor at all times. This ensures stability and helps distribute weight evenly between the legs, reducing the risk of falls. Using the cane on the weak side of the body (Choice B) may not provide adequate support. Advancing the cane and the strong leg simultaneously (Choice C) can lead to imbalance and increases the risk of falls. Advancing the cane too far with each step (Choice D) can also compromise balance and stability.

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