Nursing Elites

1. A nurse is caring for a client following an appendectomy. The nurse verifies the postoperative prescription which reads, 'Discontinue NPO status; advance diet as tolerated.' Which of the following are appropriate for the nurse to offer the client? (SATA)

• A. Wheat toast
• B. Applesauce
• C. Applesauce, Chicken broth
• D. Chicken broth

Correct answer: C

Rationale: The correct answer is C: Applesauce and chicken broth. After an appendectomy, patients are typically started on a clear liquid diet before advancing to more solid foods. Applesauce and chicken broth are part of a low-residue diet that is easily digestible and gentle on the digestive system, making them suitable choices for a client following surgery. Wheat toast may be too heavy and fibrous initially, while other solid foods should be introduced gradually to prevent gastrointestinal upset.

2. A nurse is teaching a group of clients about stress. Which of the following should the nurse include in the teaching?

• A. Protein requirements decrease in times of stress.
• B. Acute stress causes an increase in metabolism.
• C. Stress causes a positive nitrogen balance in the body.
• D. Glucose is broken down more slowly during times of stress.

Correct answer: B

Rationale: The correct answer is B: Acute stress causes an increase in metabolism. During acute stress, the body's fight-or-flight response is activated, leading to an increase in metabolism to provide energy for the body to respond to the stressor. Choices A, C, and D are incorrect. Protein requirements actually increase during times of stress to support the body's needs. Stress typically leads to a negative nitrogen balance in the body, not a positive one. Glucose is broken down more rapidly, not slowly, during times of stress to provide immediate energy.

3. A client who is postpartum and has been diagnosed with iron deficiency anemia should be taught to consume which of the following dietary recommendations?

• A. Yogurt and mozzarella
• B. Spinach and beef
• C. Milk and turkey slices
• D. Fish and cottage cheese

Correct answer: C

Rationale: The correct answer is spinach and beef. Both spinach and beef are high in iron, making them excellent choices to help combat iron deficiency anemia. Yogurt, mozzarella, milk, turkey slices, fish, and cottage cheese are not as rich in iron compared to spinach and beef, so they are not the most suitable dietary recommendations for a client with iron deficiency anemia.

4. A nurse is developing a program about strategies to prevent foodborne illnesses for a community group. The nurse should plan to include which of the following recommendations? (Select one that does not apply).

• A. Keep cold food temperatures below 4.4�C (40�F).
• B. Reheat leftovers before eating.
• C. Wash raw vegetables thoroughly in clean water.
• D. Keep cooked foods at 48.9�C (120�F).

Correct answer: D

Rationale: The correct answer is to keep cooked foods at 48.9�C (120�F). This temperature is too low to keep cooked foods safe from bacterial growth. The ideal temperature to keep cooked foods safe is above 60�C (140�F). Choices A, B, and C are all important strategies to prevent foodborne illnesses. Keeping cold food temperatures below 4.4�C (40�F) helps prevent bacterial growth, reheating leftovers before eating kills any bacteria that may have grown during storage, and washing raw vegetables thoroughly in clean water helps remove dirt and bacteria.

5. A nurse is caring for a client who has cancer and is receiving total parenteral nutrition (TPN). Which of the following lab values indicates the treatment is effective?

• A. Hct 43%
• B. WBC 8,000/uL
• C. Albumin 4.2 g/dL
• D. Calcium 9.4 mg/dL

Correct answer: C

Rationale: The correct answer is Albumin 4.2 g/dL. Albumin is a protein produced by the liver and is a key indicator of nutritional status. In a client receiving total parenteral nutrition (TPN), an increase in albumin level indicates that the treatment is effective in providing adequate nutrition support. Hct (hematocrit), WBC (white blood cell count), and calcium levels are not direct indicators of the effectiveness of TPN in this context.

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