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 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 client with chronic pancreatitis is receiving discharge teaching from a nurse. Which of the following statements should the nurse make?

• A. "You should decrease your caloric intake when experiencing abdominal pain."?
• B. "You should increase your daily intake of protein."?
• C. "You should increase fat intake when experiencing loose stools."?
• D. "You should limit alcohol intake to 2-3 drinks per week."?

Correct answer: B

Rationale: In chronic pancreatitis, it is important to increase protein intake to support healing and prevent malnutrition. Choice A is incorrect because decreasing caloric intake during abdominal pain may lead to further nutritional deficiencies. Choice C is incorrect as increasing fat intake can exacerbate symptoms due to the impaired fat digestion in chronic pancreatitis. Choice D is incorrect as alcohol should be completely avoided in chronic pancreatitis to prevent further damage to the pancreas.

4. Risk factors that have been shown to contribute to age-related macular degeneration include _____.

• A. oxidative stress from sunlight
• B. iron-deficiency anemia
• C. decreased intake of phytochemicals
• D. vitamin B6 malabsorption

Correct answer: A

Rationale: The correct answer is A: oxidative stress from sunlight. Oxidative stress caused by exposure to sunlight is a significant risk factor for age-related macular degeneration. This condition can result in vision loss among older individuals. Choices B, C, and D are incorrect. Iron-deficiency anemia, decreased intake of phytochemicals, and vitamin B6 malabsorption are not established risk factors for age-related macular degeneration.

5. A nurse is providing teaching to a client with gastroesophageal reflux. Which of the following statements by the client indicates a need for further teaching?

• A. I should elevate the head of my bed while sleeping.
• B. I drink no more than 4 cups of coffee a day.
• C. I take my time when I am eating.
• D. I avoid foods and drinks made with chocolate.

Correct answer: B

Rationale: The correct answer is B: 'I drink no more than 4 cups of coffee a day.' Excessive coffee consumption can aggravate gastroesophageal reflux due to its acidic nature. Choices A, C, and D are all appropriate self-care measures for managing gastroesophageal reflux. Elevating the head of the bed while sleeping helps prevent acid reflux, eating slowly can reduce reflux episodes, and avoiding trigger foods like chocolate can help alleviate symptoms.

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