Nursing Elites

1. A client with chronic pancreatitis is receiving discharge teaching from a nurse. Which of the following statements should the nurse make?

• A. "You should decrease your caloric intake when experiencing abdominal pain."?
• B. "You should increase your daily intake of protein."?
• C. "You should increase fat intake when experiencing loose stools."?
• D. "You should limit alcohol intake to 2-3 drinks per week."?

Correct answer: B

Rationale: In chronic pancreatitis, it is important to increase protein intake to support healing and prevent malnutrition. Choice A is incorrect because decreasing caloric intake during abdominal pain may lead to further nutritional deficiencies. Choice C is incorrect as increasing fat intake can exacerbate symptoms due to the impaired fat digestion in chronic pancreatitis. Choice D is incorrect as alcohol should be completely avoided in chronic pancreatitis to prevent further damage to the pancreas.

2. A breastfeeding mother complains that she missed her son's last two feedings and now her breasts have become full, hard, and uncomfortable. This condition is known as _____.

• A. mastitis
• B. engorgement
• C. letdown
• D. galactorrhea

Correct answer: B

Rationale: Engorgement occurs when the breasts become overly full, leading to discomfort and sometimes difficulty with latching. It can be relieved by feeding or expressing milk. Mastitis, choice A, is characterized by breast inflammation usually caused by an infection. Letdown, choice C, refers to the release of milk from the breast. Galactorrhea, choice D, is the spontaneous flow of milk from the breast unassociated with childbirth or nursing.

3. Each of the following is a form of vitamin K, except one. Which is the exception?

• A. Phylloquinone
• B. Tocopherol
• C. Menaquinone
• D. Menadione

Correct answer: B

Rationale: Tocopherol, Choice B, is not a form of vitamin K; it is another name for vitamin E. Phylloquinone (Choice A), menaquinone (Choice C), and menadione (Choice D) are all forms of vitamin K. Phylloquinone is vitamin K1 found in green plants, menaquinone is vitamin K2 produced in the large intestine and found in animal tissues, and menadione is a synthetic form of vitamin K. Therefore, Choice B is the correct answer because it does not belong to the vitamin K group, unlike the other options.

4. Which vitamin's recommended dietary allowance (RDA) is significantly increased during pregnancy?

• A. Folate
• B. Thiamine (B1)
• C. Riboflavin (B2)
• D. Niacin (B3)

Correct answer: A

Rationale: The correct answer is A: Folate. During pregnancy, the recommended dietary allowance (RDA) for folate is significantly increased to support fetal development and prevent neural tube defects and other congenital anomalies. Folate plays a crucial role in DNA synthesis and cell growth, making it essential for the rapidly dividing cells of the developing fetus. Thiamine (B1), Riboflavin (B2), and Niacin (B3) are important vitamins, but their RDAs do not undergo as significant an increase during pregnancy as folate's RDA does.

5. While evaluating the meal choices of a client with major depressive disorder and a prescription of Phenelzine, which of the following selections should the nurse identify as appropriate?

• A. Cheddar cheese
• B. Smoked salmon
• C. Strawberry yogurt
• D. Pepperoni pizza

Correct answer: C

Rationale: The correct answer is C, 'Strawberry yogurt.' This choice is appropriate because it does not contain high levels of tyramine, which can lead to a dangerous interaction with Phenelzine, a monoamine oxidase inhibitor. Tyramine-rich foods, like aged cheeses (such as cheddar cheese) and cured meats (like smoked salmon and pepperoni), should be avoided by individuals taking Phenelzine to prevent hypertensive crisis. Strawberry yogurt is a safer option for the client in this scenario.

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