Nursing Elites

1. A client is being educated by a nurse on snacks suitable for a low-fat, low-sodium, and low-cholesterol diet. Which of the following food choices by the client indicates the need for further teaching?

• A. A slice of cheese
• B. A jam sandwich
• C. A cup of plain popcorn
• D. A small container of applesauce

Correct answer: A

Rationale: The correct answer is A: A slice of cheese. Cheese is high in fat, sodium, and cholesterol, making it unsuitable for a low-fat, low-sodium, and low-cholesterol diet. Choices B, C, and D are more appropriate for such a diet. B: A jam sandwich can be low in fat, sodium, and cholesterol if made with whole grain bread and a low-sugar jam. C: A cup of plain popcorn is a good choice as it is low in fat and can be made without added salt. D: A small container of applesauce is also a suitable option for a low-fat, low-sodium, and low-cholesterol diet.

2. A nurse is providing teaching to an obese client who has gestational diabetes and is at 25 weeks of gestation. Which of the following statements made by the client indicates a need for further teaching?

• A. This does not mean that my baby will have this disease.
• B. This means that I will have diabetes for the rest of my life.
• C. If I feel dizzy, I should drink six ounces of a non-diet soda.
• D. Being obese might be one reason why I developed diabetes.

Correct answer: B

Rationale: The statement 'This means that I will have diabetes for the rest of my life' indicates a need for further teaching. Gestational diabetes often resolves after pregnancy, although it does indicate a higher risk for developing type 2 diabetes in the future. The other choices are correct or provide appropriate information: A) Understanding that gestational diabetes does not mean the baby will have the disease is accurate. C) Advising to drink non-diet soda if feeling dizzy is incorrect and potentially harmful due to the sugar content. D) Recognizing that obesity can be a risk factor for developing diabetes is a valid statement.

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. Each of the following accurately describes aspects of the dietary reference intakes (DRIs) published by the Food and Nutrition Board of the Institute of Medicine (IOM) except one. Which one is the exception?

• A. The DRIs replace the older recommended daily allowances.
• B. Current DRIs attempt to estimate required nutrients to improve long-term health.
• C. DRIs specifically address individuals whose requirements are affected by a disease state.
• D. The DRIs attempt to establish maximum safe levels of tolerance for nutrients.

Correct answer: C

Rationale: The correct answer is C. DRIs do not specifically address individuals with disease states; they are intended for the general healthy population. Choice A is correct because DRIs indeed replace the older recommended daily allowances. Choice B is correct as current DRIs aim to estimate required nutrients to enhance long-term health. Choice D is accurate as DRIs also attempt to establish maximum safe levels of tolerance for nutrients.

5. This flip-over card is usually kept in a portable file at the Nurse’s Station. It has 2-parts: the activity and treatment section and a nursing care plan section. This carries information about basic demographic data, primary medical diagnosis, current orders of the physician to be carried out by the nurse, written nursing care plan, nursing orders, scheduled tests and procedures, safety precautions in patient care and factors related to daily living activities. This record is used in the charge-of-shift reports or during the bedside rounds or walking rounds. What record is this?

• A. Discharge Summary
• B. Medicine and Treatment Record
• C. Nursing Health History and Assessment Worksheet
• D. Nursing Kardex

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.

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