Nursing Elites

1. A nurse is providing discharge teaching for a client who has acute pancreatitis and has a prescription for fat-soluble vitamin supplements. The nurse should instruct the client to take a supplement for which of the following?

• A. Vitamin A
• B. Vitamin B1
• C. Vitamin C
• D. Vitamin B12

Correct answer: A

Rationale: In acute pancreatitis, malabsorption of fat-soluble vitamins can occur due to pancreatic enzyme insufficiency. Vitamin A is a fat-soluble vitamin that may need supplementation in this case. Vitamin B1 (thiamine), Vitamin C, and Vitamin B12 are water-soluble vitamins and are not typically affected by pancreatic enzyme insufficiency in acute pancreatitis. Therefore, the correct supplement for the client with acute pancreatitis is Vitamin A.

2. One of the most common factors that compromise the vitamin D status of older adults, particularly those living in assisted living communities is _____.

• A. decreased intake of fruits and vegetables
• B. lack of physical activity
• C. malabsorption due to atrophic gastritis
• D. lack of exposure to sunlight

Correct answer: D

Rationale: The correct answer is 'D: lack of exposure to sunlight.' Older adults, especially those in assisted living communities, are at risk of vitamin D deficiency due to spending most of their time indoors, which reduces their exposure to sunlight. Sunlight is essential for the body to produce vitamin D. Choices A, B, and C are less likely to be major factors in compromising vitamin D status. While a decreased intake of fruits and vegetables and lack of physical activity can impact overall health, they are not as directly related to vitamin D status. Malabsorption due to atrophic gastritis may affect the absorption of certain nutrients, but vitamin D synthesis primarily depends on sunlight exposure.

3. What would a diet manual most likely contain?

• A. Procedures for disinfecting cooking surfaces
• B. Staff sanitation guidelines
• C. Information on specific patients' resting metabolic rates
• D. Specific food preparation methods

Correct answer: D

Rationale: A diet manual typically contains guidance on specific food preparation methods to ensure proper nutrition and health for individuals following the diet. Therefore, choice D is correct. Choices A and B refer to sanitation procedures and staff hygiene issues, which are important but not typically the focus of a diet manual. Choice C, regarding specific patients' resting metabolic rates, is too individualized and detailed for a general diet manual, as it would be part of a personalized dietary plan developed with a healthcare professional.

4. How long can Vitamin A be stored in the liver for at least?

• A. 1 month.
• B. 6 months.
• C. 1 year.
• D. 18 months.

Correct answer: C

Rationale: Vitamin A can be stored in the liver to meet basic needs for at least 1 year. This storage capacity allows the body to have a reserve of Vitamin A to sustain its needs over an extended period. Choices A, B, and D are incorrect because they underestimate the storage capacity of Vitamin A in the liver, which can last longer than these durations.

5. A nurse is planning care for a client who has ascites secondary to liver disease. Which of the following interventions should the nurse include in the plan of care?

• A. Reduce complex carbohydrates to 30% of total calories.
• B. Restrict protein intake to less than 0.8 g/kg/day.
• C. Decrease daily caloric intake by 20%.
• D. Limit sodium to 2000 mg or less per day.

Correct answer: D

Rationale: The correct answer is to limit sodium to 2000 mg or less per day. Ascites, which is the abnormal accumulation of fluid in the abdominal cavity, is commonly associated with liver disease. Limiting sodium intake helps manage fluid retention by reducing the fluid accumulation in the abdomen. Choices A, B, and C are incorrect because reducing complex carbohydrates, restricting protein intake, or decreasing caloric intake are not the primary interventions for managing ascites in liver disease.

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