Nursing Elites

1. What is a major feature of the therapeutic lifestyle changes (TLC) recommended for the treatment of high blood cholesterol?

• A. Avoiding all foods that contain cholesterol
• B. Reducing sodium intake to less than 2 g/day
• C. Limiting total fat intake to less than 30% of energy intake
• D. Limiting saturated fat intake to less than 7% of energy intake

Correct answer: D

Rationale: The correct answer is D, 'Limiting saturated fat intake to less than 7% of energy intake.' This is a central feature of the therapeutic lifestyle changes (TLC) recommended for treating high blood cholesterol. Saturated fats can increase low-density lipoprotein (LDL) cholesterol, a significant risk factor for heart disease. Choice A is incorrect because while it is recommended to limit cholesterol intake, it's not suggested to avoid all foods containing cholesterol entirely in the TLC. Choice B is also incorrect as although reducing sodium intake is beneficial for controlling blood pressure, it's not specifically targeted in the TLC for managing high cholesterol. Lastly, while limiting total fat intake is a healthy guideline, it's not as specific or effective as limiting saturated fat intake, making choice C also incorrect.

2. Which set of guidelines is intended to assess nutrient adequacy or plan intake of a population group, not individuals?

• A. RDA
• B. EAR
• C. DRA
• D. UL

Correct answer: B

Rationale: The Estimated Average Requirement (EAR) is the correct choice because it is specifically designed to assess the nutrient adequacy of population groups, not individuals. The Recommended Dietary Allowance (RDA) (choice A) is the average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%-98%) healthy individuals in a particular life stage and gender group. The Dietary Reference Intake (DRI) (choice C) includes the EAR, RDA, Adequate Intake (AI), and UL, making it a broader set of nutrient reference values. The Tolerable Upper Intake Level (UL) (choice D) is the highest average daily nutrient intake level that is likely to pose no risk of adverse health effects to almost all individuals in the general population.

3. Which dietary approach is most beneficial for managing hypertension?

• A. Increasing caffeine intake
• B. Reducing sodium intake
• C. Increasing dietary cholesterol
• D. Reducing fiber intake

Correct answer: B

Rationale: Reducing sodium intake is the most beneficial dietary approach for managing hypertension. High sodium intake can lead to increased blood pressure, so lowering sodium intake is crucial in managing hypertension. Choices A, C, and D are incorrect because increasing caffeine intake, dietary cholesterol, or reducing fiber intake are not recommended dietary approaches for managing hypertension and may even have adverse effects on blood pressure levels.

4. Which of the following nursing interventions is appropriate after a total thyroidectomy?

• A. Place pillows under your patient’s shoulders.
• B. Raise the knee-gatch to 30 degrees
• C. Keep you patient in a high-fowler’s position.
• D. Support the patient’s head and neck with pillows and sandbags.

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

5. All of the following are instructions for proper foot care to be given to a client with peripheral vascular disease caused by diabetes. Which one is not?

• A. Trim nails using a nail clipper
• B. Apply cornstarch to the foot
• C. Always check the temperature of the water before bathing
• D. Use canvas shoes

Correct answer: A

Rationale: The correct answer is 'A', which says trim nails using a nail clipper. This is incorrect because patients with peripheral vascular disease, particularly those caused by diabetes, should not trim their nails themselves due to the risk of injury, infection, and poor wound healing. The other options, 'B', 'C', and 'D', are correct advice for diabetic foot care. Applying cornstarch can help keep the feet dry and prevent fungal infections. Checking the water temperature before bathing can prevent burns, as patients with peripheral vascular disease often have decreased sensation in their feet. Wearing canvas shoes can improve foot ventilation and reduce the risk of foot ulcers and infections.

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