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. What is the glomerular filtration rate for patients with stage 5 chronic kidney disease (CKD)?

• A. Less than 15 mL/min/1.73 m�
• B. Less than 30 mL/min/1.73 m�
• C. Less than 90 mL/min/1.73 m�
• D. Less than 125 mL/min/1.73 m�

Correct answer: A

Rationale: In patients with stage 5 chronic kidney disease (CKD), also known as end-stage renal disease, the kidney function is significantly compromised. This severe condition is characterized by a glomerular filtration rate (GFR) of less than 15 mL/min/1.73 m�, as correctly stated in choice A. Choices B, C, and D suggest higher GFR values, which are not indicative of stage 5 CKD. Specifically, a GFR of less than 30 mL/min/1.73 m� indicates stage 4 CKD, less than 90 mL/min/1.73 m� signifies stage 3 CKD, and a typical healthy individual usually has a GFR of around 125 mL/min/1.73 m�, which is far above the GFR for stage 5 CKD.

3. A client is prescribed a 1500-calorie diet. Thirty percent of the calories are to be derived from fat. How many grams of fat should the nurse tell the client to consume per day? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

• A. 21
• B. 49
• C. 60
• D. 50

Correct answer: D

Rationale: To calculate the grams of fat, first, determine the calories from fat by multiplying the total calorie intake (1500 calories) by the percentage of calories from fat (30%), which equals 450 calories from fat. Since 1 gram of fat is equivalent to 9 calories, divide the total calories from fat (450) by the calories in 1 gram of fat (9) to get the answer in grams, which is 50. Therefore, the client should consume 50 grams of fat per day. Choice A (21), Choice B (49), and Choice C (60) are incorrect as they do not reflect the accurate calculation based on the given information.

4. Has Healthy People (HP 2020), issued by the U.S. Department of Health and Human Services, resulted in a reduction of deaths from cardiovascular disease, stroke, and some cancers, as well as decreased dental caries in children aged 2 to 4 years and adults aged 53 to 44 years?

• A. Yes, both statements are true.
• B. No, 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: B

Rationale: Both statements are false. While Healthy People (HP 2020) has contributed to a reduction in deaths from cardiovascular disease, stroke, and some cancers, it did not result in decreased dental caries in children aged 2 to 4 years and adults aged 53 to 44 years. Therefore, the correct answer is B. Choice A is incorrect because the second statement is false. Choice C is incorrect as the first statement is also false. Choice D is incorrect as the second statement is false.

5. A healthcare provider is teaching a client who has constipation about a high-fiber diet. Which of the following foods should be included as sources of fiber? (Select one that does not apply.)

• A. Whole wheat bread
• B. Kidney beans
• C. Refined cereals
• D. Blackberries

Correct answer: C

Rationale: Refined cereals are not a good source of fiber as they have been processed and stripped off most of their fiber content. Whole wheat bread, kidney beans, and blackberries are excellent sources of fiber. Whole wheat bread is made from whole grains, which are high in fiber. Kidney beans are rich in fiber and can help alleviate constipation. Blackberries are a good source of fiber and can aid in promoting bowel regularity.

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