Nursing Elites

1. A nurse is completing an admission assessment on an adolescent client who is a vegetarian. He eats milk products but does not like beans. Which of the following items should the nurse suggest the client order for lunch to provide the nutrients most likely to be lacking in his diet?

• A. Peanut butter and jelly sandwich
• B. Baked potato topped with sour cream
• C. Bagel with cream cheese
• D. Fruit salad

Correct answer: D

Rationale: The correct answer is 'Fruit salad.' Since the adolescent client is a vegetarian who eats milk products but does not like beans, suggesting a fruit salad for lunch would provide essential nutrients like vitamins, minerals, and fiber that are commonly found in fruits. Fruit salad can help supplement the nutrients that may be lacking in his diet. Choices A, B, and C do not offer the same variety and quantity of nutrients as a fruit salad, making them less optimal choices for meeting the client's dietary needs.

2. A nurse is teaching a nutrition class for clients who have type 2 diabetes mellitus. Which of the following statements should the nurse include about management of acute illness?

• A. Consume carbs every 3-4 hrs
• B. Decrease fluid intake to 1000 mL per day
• C. Monitor blood glucose twice per day
• D. Check urine for ketones every 24 hrs

Correct answer: A

Rationale: The correct statement is to 'Consume carbs every 3-4 hours.' During acute illness, it is important to maintain a consistent carbohydrate intake to help manage blood glucose levels for clients with type 2 diabetes. This frequent consumption can prevent hypoglycemia and provide energy needed during illness. Decreasing fluid intake (choice B) is not recommended during acute illness, as hydration is crucial to prevent complications. Monitoring blood glucose (choice C) more frequently than twice a day is necessary during acute illness. Checking urine for ketones (choice D) should be done more frequently than once every 24 hours during illness to monitor for diabetic ketoacidosis.

3. Children with cerebral palsy, Down syndrome, and intellectual disabilities are likely to have abnormal sensory input and muscle tone. A small, underdeveloped tongue is common in many such disorders and results in diminished nutritional status.

• A. Both statements are true
• B. Both statements are false
• C. The first statement is true; the second is false
• D. The first statement is false; the second is true

Correct answer: C

Rationale: The first statement is true, but the second is false. These children often have a large tongue or tongue thrust, which can interfere with feeding and nutrition.

4. The nurse is completing a nutritional assessment on a client. Which statement made by the client is most concerning to the nurse?

• A. "I notice when I take a vitamin E supplement, I bruise more easily."
• B. "I work nights and rarely go outside during the day."
• C. "I take warfarin, so I need to limit the amount of green leafy vegetables I eat."
• D. "My vitamin supplement has the recommended daily allowance of vitamin A."

Correct answer: A

Rationale: The correct answer is A. Excessive intake of vitamin E can increase the risk of bleeding as it acts as a blood thinner. Bruising easily may indicate too much vitamin E. Choice B is not as concerning as it describes a lifestyle that may lead to vitamin D deficiency due to lack of sunlight exposure. Choice C shows awareness of the interaction between warfarin and vitamin K, which is expected. Choice D indicates knowledge of the vitamin A content in the supplement, which is not a cause for concern.

5. Which individual would be at the greatest risk for deficiencies in water-soluble vitamins?

• A. An individual who regularly consumes fruits and vegetables.
• B. An individual with a high intake of dairy products.
• C. An individual who consumes a diet high in processed foods.
• D. An individual who frequently eats organ meats.

Correct answer: C

Rationale: The correct answer is 'An individual who consumes a diet high in processed foods.' Processed foods are often deficient in water-soluble vitamins such as vitamin C and B vitamins, which can lead to deficiencies. On the other hand, fruits, vegetables, and organ meats are rich sources of these vitamins, so individuals who consume these regularly are less likely to develop deficiencies. While dairy products do contain some water-soluble vitamins, they are not depleted as quickly as they are in a diet high in processed foods, making a deficiency less likely.

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