Nursing Elites

1. A client is being taught how to follow a low-purine diet for gout management. Which statement indicates the client understands the teaching?

• A. "I will need to limit the number of fruit servings each day."?
• B. "I should avoid eating liver and other organ meats."?
• C. "I can drink only white wine."?
• D. "I should choose red meat instead of poultry."?

Correct answer: B

Rationale: The correct answer is B. Organ meats like liver are high in purines, which can exacerbate gout symptoms. Choosing to avoid such foods is essential in following a low-purine diet. Option A is incorrect because fruits are generally low in purines and are not usually restricted in a low-purine diet. Option C is incorrect as white wine, just like other types of alcohol, should be consumed in moderation or avoided due to its purine content. Option D is incorrect because red meat, including beef and lamb, is high in purines and should be limited in a low-purine diet.

2. Which foods are the biggest contributors of saturated fats consumed by Americans?

• A. Butter, coconut, and palm oils
• B. Corn oil
• C. Meat and milk
• D. Cheese, pizza, desserts, and chicken

Correct answer: D

Rationale: The correct answer is D: Cheese, pizza, desserts, and chicken. These foods are significant contributors to the intake of saturated fats in the American diet, often found in processed and fast foods. Choices A, B, and C are incorrect because while butter, coconut, and palm oils (A) are sources of saturated fats, they are not the biggest contributors in the American diet. Corn oil (B) is a source of unsaturated fats, and meat and milk (C) contain saturated fats but are not the primary contributors compared to cheese, pizza, desserts, and chicken.

3. The nurse is assessing a client with a new diagnosis of Listeria food poisoning. What action should the nurse take first?

• A. Educate the client on safe food practices.
• B. Start a traceback to identify the source of the outbreak.
• C. Report the case to the county board of health.
• D. Ask the client if they have consumed any unpasteurized products.

Correct answer: D

Rationale: The correct first action for the nurse to take when assessing a client with a new diagnosis of Listeria food poisoning is to inquire if the client has consumed any unpasteurized products. This is crucial because Listeria contamination is often associated with unpasteurized dairy products and undercooked meats. Educating the client on safe food practices (Choice A) is important but not the priority at this initial assessment stage. Starting a traceback to identify the source of the outbreak (Choice B) and reporting the case to the county board of health (Choice C) are necessary actions but should come after gathering information directly from the client regarding potential exposure to high-risk foods.

4. What is a major feature of the therapeutic lifestyle changes (TLC) recommended for the treatment of high blood cholesterol?

• A. Avoiding all foods that contain cholesterol
• B. Reducing sodium intake to less than 2 g/day
• C. Limiting total fat intake to less than 30% of energy intake
• D. Limiting saturated fat intake to less than 7% of energy intake

Correct answer: D

Rationale: The correct answer is D, 'Limiting saturated fat intake to less than 7% of energy intake.' This is a central feature of the therapeutic lifestyle changes (TLC) recommended for treating high blood cholesterol. Saturated fats can increase low-density lipoprotein (LDL) cholesterol, a significant risk factor for heart disease. Choice A is incorrect because while it is recommended to limit cholesterol intake, it's not suggested to avoid all foods containing cholesterol entirely in the TLC. Choice B is also incorrect as although reducing sodium intake is beneficial for controlling blood pressure, it's not specifically targeted in the TLC for managing high cholesterol. Lastly, while limiting total fat intake is a healthy guideline, it's not as specific or effective as limiting saturated fat intake, making choice C also incorrect.

5. The PACU nurse will maintain postoperative T and A client in what position?

• A. Supine with neck hyperextended and supported with pillow
• B. Prone with the head on pillow and turned to the side
• C. Semi-fowler’s with neck flexed
• D. Reverse trendelenburg with extended neck

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.

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