Nursing Elites

1. What is the most likely complication for a client receiving TPN who suddenly develops tremors, dizziness, and diaphoresis?

• A. Fluid volume overload
• B. Sepsis
• C. Hyperglycemia
• D. Hypoglycemia

Correct answer: D

Rationale: The correct answer is D, Hypoglycemia. When a client receiving TPN suddenly develops tremors, dizziness, and diaphoresis, it is indicative of hypoglycemia. TPN provides a high concentration of glucose, and if it is abruptly stopped or the infusion rate is reduced, it can lead to hypoglycemia. Choices A, B, and C are incorrect as they do not directly correlate with the symptoms described in the scenario. Fluid volume overload typically presents with edema and hypertension, sepsis with fever and increased heart rate, and hyperglycemia with polyuria, polydipsia, and blurred vision.

2. A nurse is caring for a client following an appendectomy. The nurse verifies the postoperative prescription which reads, 'Discontinue NPO status; advance diet as tolerated.' Which of the following are appropriate for the nurse to offer the client? (SATA)

• A. Wheat toast
• B. Applesauce
• C. Applesauce, Chicken broth
• D. Chicken broth

Correct answer: C

Rationale: The correct answer is C: Applesauce and chicken broth. After an appendectomy, patients are typically started on a clear liquid diet before advancing to more solid foods. Applesauce and chicken broth are part of a low-residue diet that is easily digestible and gentle on the digestive system, making them suitable choices for a client following surgery. Wheat toast may be too heavy and fibrous initially, while other solid foods should be introduced gradually to prevent gastrointestinal upset.

3. A nurse is providing discharge teaching about food choices to a client who has hypokalemia. Which of the following foods should the nurse identify as the best source of potassium?

• A. 1 cup grapes
• B. 1 cup shredded lettuce
• C. 1 cup cooked tomatoes
• D. 1 cup apple slices

Correct answer: C

Rationale: Cooked tomatoes are high in potassium, which is crucial for maintaining normal cell function, nerve transmission, and muscle contraction, making them a suitable choice for addressing hypokalemia. Grapes, shredded lettuce, and apple slices do not contain as much potassium as cooked tomatoes, so they are not the best choice for addressing hypokalemia.

4. A dietitian tells you that you are not consuming enough calories. Which of the following nutrients could you add to your diet to increase your energy intake?

• A. fiber
• B. water
• C. protein
• D. vitamins

Correct answer: C

Rationale: Corrected Rationale: Protein provides 4 kcal per gram, making it a good source of energy to increase caloric intake. While fiber and water are important for other aspects of health, they do not provide energy like protein does. Vitamins are essential for various bodily functions but do not contribute directly to caloric intake.

5. What is the purpose of a chest tube after a lobectomy procedure, as understood by the nurse?

• A. Prevent mediastinal shift
• B. Promote chest expansion of the remaining lung
• C. Drain fluids and blood accumulated post-operatively
• D. Remove the air in the lungs to promote lung expansion

Correct answer: C

Rationale: After a lobectomy, a chest tube is typically inserted to drain fluids and blood that may have accumulated post-operatively. This tube helps to prevent complications, such as infections or pneumonia, and aids in patient recovery. While a chest tube may aid in preventing a mediastinal shift (Choice A), promoting chest expansion of the remaining lung (Choice B), and removing air in the lungs to promote lung expansion (Choice D), these are not the primary reasons for its use after a lobectomy. Therefore, Choices A, B, and D are incorrect.

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