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. Each statement is true of fat-soluble vitamins, except one. Which is the exception?

• A. Fairly stable to heat, such as during cooking
• B. Contain carbon
• C. Stored in the pancreas
• D. Absorbed in the intestine along with fats and lipids in food

Correct answer: C

Rationale: Fat-soluble vitamins are not stored in the pancreas; they are stored in the liver and fatty tissues. Choice A is correct as fat-soluble vitamins are fairly stable to heat. Choice B is also correct as fat-soluble vitamins contain carbon. Choice D is correct as fat-soluble vitamins are absorbed in the intestine along with fats and lipids in food.

3. What is the glomerular filtration rate for patients with stage 5 chronic kidney disease (CKD)?

• A. Less than 15 mL/min/1.73 m�
• B. Less than 30 mL/min/1.73 m�
• C. Less than 90 mL/min/1.73 m�
• D. Less than 125 mL/min/1.73 m�

Correct answer: A

Rationale: In patients with stage 5 chronic kidney disease (CKD), also known as end-stage renal disease, the kidney function is significantly compromised. This severe condition is characterized by a glomerular filtration rate (GFR) of less than 15 mL/min/1.73 m�, as correctly stated in choice A. Choices B, C, and D suggest higher GFR values, which are not indicative of stage 5 CKD. Specifically, a GFR of less than 30 mL/min/1.73 m� indicates stage 4 CKD, less than 90 mL/min/1.73 m� signifies stage 3 CKD, and a typical healthy individual usually has a GFR of around 125 mL/min/1.73 m�, which is far above the GFR for stage 5 CKD.

4. The nurse is working with a patient who recently had a stroke. The patient frequently chokes and coughs when eating and is having difficulty feeding herself. What is the best way to ensure adequate nutrition?

• A. to have an aide feed her at each meal
• B. to ask a family member to assist during meals
• C. to provide tube feedings for the patient
• D. to initiate TPN for the patient

Correct answer: C

Rationale: The best way to ensure adequate nutrition for a stroke patient who frequently chokes and coughs when eating and has difficulty feeding herself is to provide tube feedings. Tube feedings are a safe and effective method to deliver nutrition directly to the stomach or intestines, bypassing the swallowing mechanism, reducing the risk of aspiration. Having an aide feed her each meal (choice A) may not address the underlying issue of swallowing difficulty and aspiration risk. Asking a family member to be present at each meal (choice B) does not provide a definitive solution to the patient's nutritional needs. Placing the patient on total parenteral nutrition (TPN) (choice D) is a more invasive and typically reserved for patients who cannot tolerate enteral feedings or have non-functional gastrointestinal tracts.

5. What is the term for a condition where one or more members of a household, including children, consistently have little or no food due to lack of money?

• A. Marginal Food Security
• B. Food Desert
• C. Very Low Food Security
• D. Food Insecurity

Correct answer: D

Rationale: The correct answer is 'D: Food Insecurity'. This term specifically describes a situation where household members consistently have inadequate access to food due to financial constraints. 'Marginal Food Security' (Choice A) refers to a situation where the quality or variety of food is reduced, but there is no significant decrease in food intake. A 'Food Desert' (Choice B) is an area with limited access to affordable and nutritious food. 'Very Low Food Security' (Choice C) is a term used to describe a severe level of food insecurity where eating patterns of household members are disrupted and food intake is reduced.

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