Nursing Elites

1. A nurse is providing dietary teaching for a client who has just learned that she has type 2 diabetes mellitus. The nurse should explain that which of the following sweeteners will add calories to the client's carbohydrate count?

• A. Sorbitol
• B. Sucralose
• C. Aspartame
• D. Acesulfame potassium

Correct answer: A

Rationale: Sorbitol is a sweetener that will add calories to the client's carbohydrate count. It is a sugar alcohol that provides about 2.6 calories per gram. Sucralose, aspartame, and acesulfame potassium are all non-nutritive sweeteners that do not contribute significant calories to the diet. Sucralose is about 600 times sweeter than sucrose but does not add calories. Aspartame is a low-calorie sweetener that is approximately 200 times sweeter than sucrose, and acesulfame potassium is a calorie-free sweetener.

2. Which of the following is a good food source of iodine?

• A. Seafood
• B. Lettuce
• C. Broccoli
• D. Pork

Correct answer: A

Rationale: Seafood is a rich source of iodine, essential for maintaining healthy thyroid function and overall metabolic health. While lettuce, broccoli, and pork may contain some iodine, they do not provide as substantial an amount as seafood. Therefore, they are not considered 'good' sources of iodine in comparison.

3. A nurse is planning care for a client who reports increasing difficulty swallowing food. Which of the following interventions should the nurse plan to take?

• A. Turn on the client’s television during meals.
• B. Place the client into a semi-reclining position for meals.
• C. Encourage the client to rest prior to mealtimes.
• D. Encourage the client to use a straw when drinking liquids.

Correct answer: C

Rationale: The correct answer is to encourage the client to rest prior to mealtimes. This intervention can help reduce fatigue and improve the ability to swallow. Turning on the client’s television during meals (choice A) may distract the client but does not directly address the swallowing issue. Placing the client into a semi-reclining position for meals (choice B) can help with swallowing difficulties, but resting before meals is more beneficial. Encouraging the client to use a straw when drinking liquids (choice D) is not the priority intervention for swallowing difficulties in this scenario.

4. You are taking care of critically ill client and the doctor in charge calls to order a DNR (do not resuscitate) for the client. Which of the following is the appropriate action when getting DNR order over the phone?

• A. Have the registered nurse, family spokesperson, nurse supervisor and doctor sign
• B. Have 2 nurse validate the phone order, both nurses sign the order and the doctor should sign his order within 24
• C. Have the registered nurse, family and doctor sign the order
• D. Have 1 nurse take the order and sign it and have the doctor sign it within 24 hours

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

5. Major complications of diabetes include damage to the:

• A. stomach, liver, and pancreas
• B. eyes, nerves, and kidneys
• C. skin, blood vessels, and lungs
• D. brain, pituitary gland, and thyroid gland

Correct answer: B

Rationale: The correct answer is B: eyes, nerves, and kidneys. In diabetes, major complications result from damage to small blood vessels that supply these organs. Damage to the eyes can lead to retinopathy, to the nerves causing neuropathy, and to the kidneys causing nephropathy. Choices A, C, and D are incorrect as they do not represent the typical major complications associated with diabetes.

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