Nursing Elites

1. A client who is in her second trimester of pregnancy should increase her caloric intake by how many calories during this trimester?

• A. 110 cal/day
• B. 225 cal/day
• C. 340 cal/day
• D. 450 cal/day

Correct answer: C

Rationale: During the second trimester of pregnancy, it is recommended that a client increases their caloric intake by around 340 calories per day to support the growing needs of both the mother and the developing fetus. This additional intake helps ensure the proper nutrition and energy levels required during this crucial stage of pregnancy. Option A (110 cal/day) is too low to meet the increased demands. Option B (225 cal/day) is also below the recommended amount. Option D (450 cal/day) is higher than necessary and could lead to excessive weight gain, which is not ideal during pregnancy.

2. In an extreme situation and when no other resident or intern is available, should a nurse receive telephone orders, the order has to be correctly written and signed by the physician within:

• A. 24 hours
• B. 36 hours
• C. 48 hours
• D. 12 hours

Correct answer: B

Rationale: In an extreme situation where no other resident or intern is available, if a nurse receives telephone orders, the order has to be correctly written and signed by the physician within 36 hours. This time frame ensures timely documentation and validation of the orders. Choice A (24 hours) is too short a period for busy physicians to fulfill the task. Choice C (48 hours) is too long and delays the incorporation of physician orders into the patient's care plan. Choice D (12 hours) may not provide enough time for the physician to review and sign the order, especially in situations where immediate attention is not required.

3. Which animal-derived food contains the most significant level of carbohydrates?

• A. Egg
• B. Beef
• C. Milk
• D. Poultry

Correct answer: C

Rationale: Milk contains the most significant level of carbohydrates among animal-derived foods. Milk and milk products supply significant quantities of carbohydrate in the form of lactose. Eggs, beef, and poultry are not significant sources of carbohydrates compared to milk. In cheese making, lactose is removed as a by-product, reducing the carbohydrate content further.

4. A patient with renal insufficiency should limit the intake of which of the following nutrients?

• A. Phosphorus
• B. Potassium
• C. Sodium
• D. Calcium

Correct answer: A

Rationale: In patients with renal insufficiency, impaired kidney function can lead to difficulty in excreting phosphorus. High phosphorus levels can result in further complications such as bone and heart problems. Therefore, limiting the intake of phosphorus is crucial. Potassium and sodium restrictions may also be necessary in renal insufficiency, but the primary concern related to nutrients is phosphorus in this scenario. Calcium, while important for bone health, does not typically need to be restricted in renal insufficiency unless there is a specific medical reason to do so.

5. A nurse is completing a nutritional assessment of an adult female client. Which of the following findings should indicate to the nurse that the client is at an increased risk of developing cancer?

• A. Eats at least 5 servings of fruits and vegetables daily.
• B. Eats 6 servings of whole grains daily.
• C. Limits alcohol consumption to 2 drinks per day.
• D. Limits red meat intake to 3oz per day.

Correct answer: C

Rationale: The correct answer is C because limiting alcohol consumption to 2 drinks per day is still above the recommended limit for reducing cancer risk. The recommended limit for women is 1 drink per day to lower the risk of developing cancer. Choices A, B, and D are not indicative of an increased risk of developing cancer as they all align with a healthy diet and lifestyle, which can actually help reduce the risk of cancer.

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