Nursing Elites

1. A Hazard Analysis and Critical Control Points (HACCP) program would address which element of food service?

• A. cleaning and disinfecting of utensils
• B. developing healthy menus
• C. controlling patient calorie intake
• D. prescribing diets for patients with swallowing problems

Correct answer: A

Rationale: The correct answer is A. Hazard Analysis and Critical Control Points (HACCP) programs are designed to ensure food safety by identifying and controlling potential hazards. This includes addressing the cleaning and disinfecting of utensils to prevent contamination and maintain safe food handling practices. Choices B, C, and D are incorrect because HACCP primarily focuses on preventing food safety hazards rather than developing menus, controlling calorie intake, or prescribing diets for specific medical conditions.

2. Which set of guidelines is intended to assess nutrient adequacy or plan intakes of population groups, not individuals?

• A. Old Recommended Dietary Allowances (RDA)
• B. Estimated Average Requirement (EAR)
• C. New Recommended Dietary Allowances (RDA)
• D. Tolerable Upper Intake Level (UL)

Correct answer: B

Rationale: The Estimated Average Requirement (EAR) is specifically designed to assess nutrient adequacy or plan intakes for population groups, not for individuals. The Old and New Recommended Dietary Allowances (RDA) are meant for individuals, not groups, as they provide guidelines for specific nutrient intake levels for healthy individuals. The Tolerable Upper Intake Level (UL) is used to set the highest level of nutrient intake that is likely to pose no risk of adverse health effects for most individuals in a group, which is different from assessing nutrient adequacy for groups.

3. Fat-soluble vitamins are different from water-soluble vitamins because the body is able to store only small amounts of fat-soluble vitamins.

• A. Both the statement and the reason are correct and related.
• B. Both the statement and the reason are correct but are not related.
• C. The statement is correct, but the reason is not correct.
• D. The statement is not correct, but the reason is correct.

Correct answer: C

Rationale: The statement is correct, but the reason is not correct. A major difference between fat-soluble and water-soluble vitamins is that the body is able to store larger amounts of fat-soluble vitamins. Vitamins A and D are stored for long periods; therefore, minor shortages might not be identified until drastic depletion has occurred. Observable signs and symptoms of a dietary deficiency are often not identified until they are in an advanced state. Water-soluble vitamins, on the other hand, are not stored in the body and are excreted in the urine if taken in excess, making it harder to reach toxic levels.

4. Dietary fiber has been recommended for its possible benefits in reducing heart disease by lowering blood cholesterol. How is fiber thought to play its role in lowering blood cholesterol?

• A. Insoluble fiber binds with cholesterol in the large intestine and is excreted in feces
• B. Viscous fiber binds with bile in the intestine and is excreted in feces
• C. Soluble fiber binds with cholesterol in the blood and is excreted by the liver
• D. Insoluble fiber converts to bile in the large intestine and binds with cholesterol

Correct answer: B

Rationale: The correct answer is B. Viscous (soluble) fiber binds with bile acids in the intestine, which are then excreted. The liver must use cholesterol to make more bile acids, thereby lowering blood cholesterol levels. Choice A is incorrect as insoluble fiber does not bind with cholesterol in the large intestine. Choice C is incorrect as soluble fiber does not directly bind with cholesterol in the blood. Choice D is incorrect as insoluble fiber does not convert to bile in the large intestine to bind with cholesterol.

5. What describes a criterion used to diagnose diabetes?

• A. a plasma glucose concentration of 100 mg/dL or higher after a fast of at least 12 hours
• B. a casual blood sample of 200 mg/dL or higher in a person with classic symptoms
• C. a plasma glucose concentration measured two hours after a 200-gram glucose load is 400 mg/dL or higher
• D. a HbA1C higher than 5 percent

Correct answer: B

Rationale: A casual blood sample of 200 mg/dL or higher in a person with classic symptoms is a diagnostic criterion for diabetes. This choice aligns with the typical clinical presentation of diabetes and is a key diagnostic indicator. Choices A, C, and D do not accurately reflect the established criteria for diagnosing diabetes, making them incorrect. Choice A pertains to a fasting plasma glucose level, Choice C involves a glucose challenge test, and Choice D refers to HbA1C levels, which are used for monitoring blood sugar control over time, not for diagnosing diabetes.

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