Nursing Elites

1. Which of the following food selections would need to be removed from a tray for a client recovering from thyroidectomy?

• A. Fresh apple
• B. V8 juice
• C. Mustard greens
• D. Ice cream

Correct answer: A

Rationale: The correct answer is a fresh apple. After a thyroidectomy, it is important to avoid hard and crunchy foods like apples due to the proximity of the esophagus to the surgical site. Apples can be difficult to chew and swallow, posing a risk of injury or discomfort to the patient. V8 juice, mustard greens, and ice cream are softer options that would be more suitable for a client recovering from thyroidectomy.

2. Which task would be appropriate for the LPN to perform?

• A. Changing a colostomy bag.
• B. Hanging a new bag of TPN.
• C. Drawing a peak antibiotic blood level from a central line.
• D. Administering IV pain medication to a two-day post-op client.

Correct answer: A

Rationale: The correct answer is changing a colostomy bag. This task falls within the LPN's scope of practice. LPNs are trained to provide basic nursing care, including assisting with activities of daily living and certain medical procedures like changing ostomy bags. Hanging a new bag of TPN and drawing a peak antibiotic blood level from a central line are tasks that require a higher level of training and are typically performed by RNs due to their complexity and potential risks. Administering IV pain medication to a two-day post-op client is usually the responsibility of an RN as it involves close monitoring, assessment of the client's condition, and the administration of potent medications that require a higher level of clinical judgment and expertise.

3. Which of the following statements should the nurse use to best describe a very low-calorie diet (VLCD) to a client?

• A. "This diet can be used when there is close medical supervision."?
• B. "This is a long-term treatment measure that assists obese people who can't lose weight."?
• C. "The VLCD consists of solid food items that are pureed to facilitate digestion and absorption."?
• D. "A VLCD contains very little protein."?

Correct answer: A

Rationale: The correct answer is, "This diet can be used when there is close medical supervision."? Very low-calorie diets (VLCDs) are used in the clinical treatment of obesity under close medical supervision. The diet is low in calories, high in quality protein, and has a minimum of carbohydrates to spare protein and prevent ketosis. Choice B is incorrect because VLCDs are typically short-term interventions. Choice C is incorrect because VLCDs usually consist of nutritionally complete liquid formulations, not solid food items that are pureed. Choice D is incorrect because VLCDs actually contain a high quality of protein, although the overall caloric content is very low.

4. The client seeks advice from the nurse regarding issues with flatus due to colostomy. Which food should the nurse recommend?

• A. High-fiber foods, such as bran.
• B. Cruciferous vegetables, such as cabbage, broccoli, and kale.
• C. Carbonated beverages.
• D. Yogurt.

Correct answer: D

Rationale: The correct answer is yogurt. Yogurt can help reduce gas formation in clients with a colostomy. High-fiber foods like bran can stimulate peristalsis and increase flatulence, which is not helpful in this situation. Cruciferous vegetables, such as cabbage, broccoli, and kale, and beans tend to increase gas formation. Carbonated beverages, along with smoking, chewing gum, and drinking fluids with a straw, can also increase gas formation. Therefore, the nurse should recommend yogurt to help alleviate the client's issues with flatus.

5. When administering intravenous electrolyte solution, which of the following precautions should the nurse take?

• A. Infuse hypertonic solutions cautiously.
• B. Mix no more than 60 mEq of potassium per liter of fluid.
• C. Prevent infiltration of calcium, which causes tissue necrosis and sloughing.
• D. Monitor the client's digitalis dosage for potential adjustments due to IV calcium administration.

Correct answer: C

Rationale: When administering intravenous electrolyte solutions, it is crucial to prevent infiltration of calcium to avoid tissue necrosis and sloughing. Hypertonic solutions should be infused cautiously (Choice A) to prevent adverse effects. The correct amount of potassium to be mixed in a liter of fluid is no more than 60 mEq, making Choice B incorrect. While monitoring the client's digitalis dosage for potential adjustments due to IV calcium administration is important, the statement suggesting an increased dosage is incorrect as IV calcium diminishes digitalis's action, making Choice D incorrect.

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