Nursing Elites

1. A nurse is providing MyPlate education to a client newly diagnosed with diabetes mellitus. Which plate chosen by the client indicates the teaching was effective, according to the MyPlate guidelines?

• A. 1/2 of the plate is filled with carbohydrate foods, 1/4 filled with protein foods, and 1/4 filled with fruits and vegetables
• B. 1/2 of the plate is filled with protein foods, 1/4 filled with carbohydrates, and 1/4 filled with non-starchy vegetables
• C. 1/2 of the plate is filled with carbohydrates, 1/4 filled with protein foods, and 1/4 filled with non-starchy vegetables
• D. 1/2 of the plate is filled with non-starchy vegetables, 1/4 filled with protein foods, and 1/4 filled with carbohydrate foods

Correct answer: D

Rationale: The correct answer is D. This option reflects the MyPlate guidelines for managing diabetes effectively. In diabetes management, it is essential to focus on non-starchy vegetables, appropriate protein portions, and controlled carbohydrate intake. Option A places too much emphasis on carbohydrates, which may not be suitable for diabetes. Option B swaps the proportions of protein and carbohydrates, which is not in line with the recommended distribution. Option C places too much emphasis on carbohydrates and lacks the emphasis on non-starchy vegetables, making it less suitable for diabetes management.

2. Which topical antimicrobial is most frequently used in burn wound care?

• A. Neosporin
• B. Silver nitrate
• C. Silver sulfadiazine
• D. Sulfamylon

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

3. Diet therapy for Rudy, who has acute renal failure is low-protein, low potassium and low sodium. The nutrition instructions should include:

• A. Recommend protein of high biologic value like eggs, poultry and lean meats
• B. Encourage client to include raw cucumbers, carrot, cabbage, and tomatoes
• C. Allowing the client cheese, canned foods and other processed food
• D. Bananas, cantaloupe, orange and other fresh fruits can be included in the diet

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

4. 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.

5. A nurse is caring for a client following a CVA and observes the client experiencing severe dysphagia. The nurse notifies the provider. Which of the following nutritional therapies will likely be prescribed?

• A. NPO until dysphagia subsides
• B. Supplements via nasogastric tube
• C. Initiation of total parenteral nutrition
• D. Soft residue diet

Correct answer: B

Rationale: In the scenario of severe dysphagia following a CVA, the client may have difficulty swallowing and require alternative nutritional support. Providing supplements via a nasogastric tube allows for the delivery of essential nutrients directly into the stomach, bypassing the swallowing difficulties. NPO (nothing by mouth) until dysphagia subsides may be too restrictive for the client's nutritional needs. Initiation of total parenteral nutrition is usually reserved for cases where enteral feeding is not possible or contraindicated. A soft residue diet may not be suitable for a client experiencing severe dysphagia.

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