Nursing Elites

1. Which suggestion is most appropriate to increase calorie intake for a patient with stomach cancer, aiming to prevent weight loss and wasting?

• A. Replace whole fat milk with skim milk or water
• B. Avoid peanut butter and other nuts
• C. Choose high-fat meat instead of lean meat
• D. Limit alcohol intake to two drinks per day

Correct answer: C

Rationale: The correct answer is C: Choose high-fat meat instead of lean meat. High-fat meats are more calorie-dense than lean meats, which makes them a good choice for increasing calorie intake. This is crucial for patients with stomach cancer who want to avoid weight loss and wasting. Choice A is incorrect because skim milk or water contains fewer calories than whole fat milk. Choice B is also incorrect because peanut butter and nuts are high in calories and therefore should not be avoided when trying to increase calorie intake. Finally, choice D is not a good suggestion to increase calorie intake as alcohol does not provide the necessary nutrients needed for a balanced diet. In fact, excessive alcohol can harm the liver and other organs, and it's not a reliable source of calories.

2. Increasing the variety of foods often prevents nutrient excesses and toxicities. A dietary change to eliminate or increase intake of one specific food or nutrient usually alters the intake of other nutrients.

• A. Both statements are true.
• B. Both statements are false.
• C. The first statement is true; the second is false.
• D. The first statement is false; the second is true.

Correct answer: D

Rationale: The first statement is false because increasing the variety of foods actually helps prevent nutrient excesses and toxicities. The second statement is true because making a dietary change to eliminate or increase the intake of a specific food or nutrient often leads to alterations in the intake of other nutrients. Choice A is incorrect because the first statement is false. Choice B is incorrect because the second statement is true. Choice C is incorrect because the first statement is false, even though the second statement is true.

3. Nutrition therapy for clients with diabetes is based on:

• A. low dietary intake of sugars
• B. standardized diabetic diet plans
• C. each client’s lifestyle and preferences
• D. the client’s weight and blood glucose level

Correct answer: C

Rationale: Corrected Rationale: Nutrition therapy for clients with diabetes should be individualized to each client's lifestyle, preferences, and needs. This approach ensures that the dietary plan is sustainable and tailored to the client, leading to better adherence and improved health outcomes. Choices A and B are too general and do not account for individual differences among clients. Choice D, focusing solely on weight and blood glucose levels, overlooks other crucial aspects of a client's overall well-being and dietary requirements in diabetes management.

4. What sensation is used as a gauge so that patients with ileostomy can determine how often their pouch should be drained?

• A. Sensation of taste
• B. Sensation of pressure
• C. Sensation of smell
• D. Urge to defecate

Correct answer: B

Rationale: The correct answer is B: Sensation of pressure. Patients with ileostomy can determine how often their pouch should be drained by feeling the sensation of pressure. This is important as it helps prevent leakage or overflow of the pouch. The sensation of taste (choice A) and smell (choice C) are not typically used as gauges for draining the pouch in ileostomy patients. The urge to defecate (choice D) is not relevant in this context as patients with ileostomy do not pass stool through the rectum.

5. _____ neutralizes stomach acid in the small intestine:

• A. saliva
• B. gastric mucus
• C. bicarbonate ions
• D. enzymes

Correct answer: C

Rationale: The correct answer is C: bicarbonate ions. Bicarbonate ions, secreted by the pancreas, neutralize the acidic chyme entering the small intestine from the stomach, creating a more suitable environment for digestive enzymes. Saliva (choice A) helps in the initial breakdown of food in the mouth, not in neutralizing stomach acid. Gastric mucus (choice B) protects the stomach lining from the acidic environment but does not neutralize the acid in the small intestine. Enzymes (choice D) facilitate chemical reactions in digestion but do not neutralize stomach acid.

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