Nursing Elites

1. A nurse at a provider's office is providing teaching to a client who is taking chemotherapy and losing weight. Which of the following should the nurse recommend to increase calorie and protein intake? (Select one that does not apply.)

• A. Top yogurt with fruits.
• B. Add cream to soups.
• C. Use milk instead of water in recipes.
• D. Increase fluids during meals.

Correct answer: D

Rationale: The correct recommendation to increase calorie and protein intake for a client taking chemotherapy and losing weight is to add cream to soups (choice B), as it provides additional calories and proteins. Using milk instead of water in recipes (choice C) can also increase the calorie and protein content. Topping yogurt with fruits (choice A) can be a healthy choice but may not significantly increase calorie and protein intake. Increasing fluids during meals (choice D) may fill up the stomach, potentially reducing the intake of solid foods, which is not ideal when trying to increase calorie and protein consumption.

2. Which of the following nutrients does not provide energy?

• A. Proteins
• B. Carbohydrates
• C. Fats
• D. Vitamins

Correct answer: D

Rationale: Proteins, carbohydrates, and fats are macronutrients that provide energy in the form of calories when consumed and metabolized by the body. Each gram of protein or carbohydrate provides about 4 calories, and each gram of fat provides about 9 calories. On the other hand, vitamins do not provide energy or calories. They are micronutrients that are essential for various biochemical and physiological processes in the body, including the metabolism of macronutrients. However, they do not contribute directly to the energy supply. Therefore, the correct answer is 'D: Vitamins'. Choices A, B, and C (Proteins, Carbohydrates, and Fats) are incorrect because they are macronutrients that do provide energy/calories when metabolized.

3. With which of the following should fluoride supplements never be taken?

• A. Water
• B. Juice
• C. Milk
• D. Soda

Correct answer: C

Rationale: Fluoride supplements should never be taken with milk because the fluoride binds with the calcium in the milk, thereby reducing the effectiveness of the fluoride supplement. Other beverages like water, juice, or soda do not share this characteristic as they do not contain the same level of calcium as milk. The rationale behind choosing milk as the correct answer is that it hampers the effectiveness of fluoride supplements, whereas the other choices do not.

4. Which team member works with the client to evaluate the need for special feeding devices and then teaches the client how to use the device?

• A. dietitian
• B. speech-language pathologist
• C. dietetic technician
• D. occupational therapist

Correct answer: D

Rationale: An occupational therapist is the team member who works with the client to evaluate the need for special feeding devices and teaches the client how to use them. Occupational therapists specialize in helping individuals with physical or cognitive impairments to perform daily activities. In this scenario, the need for special feeding devices may be due to impaired motor function or disability, making the occupational therapist the correct choice. The other options, dietitian, speech-language pathologist, and dietetic technician, do not typically specialize in evaluating the need for feeding devices or teaching clients how to use them.

5. The mechanism behind most CKD in patients without diabetes is mediated by:

• A. enzyme systems
• B. immune systems
• C. catabolic systems
• D. hormonal systems

Correct answer: B

Rationale: In non-diabetic patients, CKD is often mediated by immune system responses. Chronic inflammation triggered by immune system dysfunction can contribute to progressive kidney damage. Therefore, the correct answer is 'immune systems.' Choices A, C, and D are incorrect because CKD in non-diabetic patients is primarily associated with immune system abnormalities rather than enzyme, catabolic, or hormonal systems.

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