Nursing Elites

1. A nurse is providing teaching to a group of parents of newborns who are planning to formula feed. Which of the following statements by a parent indicates a need for further teaching?

• A. "I will give formula to my baby at room temperature."
• B. "I will ensure my baby's feeds last 10 to 15 minutes."
• C. "I will burp my baby halfway through each feeding."
• D. "I will watch for signs my baby is full and stop the feeding."

Correct answer: B

Rationale: The correct answer is, "I will ensure my baby's feeds last 10 to 15 minutes." This statement indicates a need for further teaching because it suggests a strict time limit for feedings, which may not be appropriate for a newborn. Newborns should be allowed to feed as long as they want, typically around 20-30 minutes per breast if breastfeeding, or on-demand with formula. Choices A, C, and D demonstrate proper feeding practices such as feeding at room temperature, burping halfway through each feeding, and watching for signs of fullness to stop the feeding, which are all appropriate responses by a parent of a formula-fed newborn.

2. What is one of the best nutritional actions a caregiver can take to help a patient with Alzheimer's disease maintain appropriate body weight?

• A. Thicken liquids to prevent choking
• B. Supervise food planning and mealtimes
• C. Assist the person in completing a grocery checklist
• D. Feed the person their meals and snacks

Correct answer: B

Rationale: The correct answer is B, 'Supervise food planning and mealtimes'. This action ensures the patient with Alzheimer's disease maintains an appropriate diet and body weight, thus reducing the risk of malnutrition. While choices A, 'Thicken liquids to prevent choking', C, 'Assist the person in completing a grocery checklist', and D, 'Feed the person their meals and snacks', might be beneficial in certain circumstances, they do not directly contribute to the maintenance of appropriate body weight as effectively as supervising food planning and mealtimes does.

3. A nurse is caring for a client who is to receive a mechanically altered diet. Which of the following client food choices necessitates intervention by the nurse?

• A. Scrambled eggs
• B. Cottage cheese
• C. Piece of wheat toast
• D. Sliced banana

Correct answer: D

Rationale: The correct answer is 'Sliced banana.' A mechanically altered diet is designed for clients who have difficulty chewing or swallowing. Sliced bananas, due to their texture and potential choking hazard for clients with swallowing difficulties, would necessitate intervention by the nurse. Scrambled eggs, cottage cheese, and a piece of wheat toast are softer and safer options for clients on a mechanically altered diet, making them appropriate choices.

4. During the later stages of chronic kidney disease, what is the recommended protein intake in grams per kilogram of body weight per day?

• A. 0.6 to 0.75
• B. 1.2 to 1.55
• C. 1.0 to 1.2
• D. 0.8 to 1.0

Correct answer: A

Rationale: In the later stages of chronic kidney disease, the recommended protein intake is typically restricted to 0.6 to 0.75 grams per kilogram of body weight per day. This lower protein intake helps reduce the workload on the kidneys, as excessive protein can be challenging for the kidneys to process. Choice B (1.2 to 1.55) is incorrect as it suggests a higher protein intake, which is not recommended for individuals with advanced kidney disease. Choices C (1.0 to 1.2) and D (0.8 to 1.0) also advocate for protein intakes higher than what is typically advised for individuals in later stages of chronic kidney disease.

5. Mr. Bruno asks what the “normal” allowable salt intake is. Your best response to Mr. Bruno is:

• A. 1 tsp of salt/day with iodine and sprinkle of MSG
• B. 5 gms per day or 1 tsp of table salt/day
• C. 1 tbsp of salt/day with some patis and toyo
• D. 1 tsp of salt/day but no patis and toyo

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.

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