Nursing Elites

1. Among people who are ill, significant weight loss may be masked by?

• A. dehydration
• B. a large tumor
• C. drug therapy
• D. fluid retention

Correct answer: D

Rationale: Fluid retention can mask weight loss in ill individuals as the retained fluid adds to body weight, making it difficult to detect true fat or muscle loss. Dehydration (Choice A) would actually lead to weight loss rather than masking it. While a large tumor (Choice B) could contribute to weight loss, it would not mask the weight loss itself. Drug therapy (Choice C) may cause side effects, including weight changes, but it is unlikely to mask significant weight loss in the same way that fluid retention does.

2. A nurse is caring for a client who has cancer and is receiving total parenteral nutrition (TPN). Which of the following lab values indicates the treatment is effective?

• A. Hct 43%
• B. WBC 8,000/uL
• C. Albumin 4.2 g/dL
• D. Calcium 9.4 mg/dL

Correct answer: C

Rationale: The correct answer is Albumin 4.2 g/dL. Albumin is a protein produced by the liver and is a key indicator of nutritional status. In a client receiving total parenteral nutrition (TPN), an increase in albumin level indicates that the treatment is effective in providing adequate nutrition support. Hct (hematocrit), WBC (white blood cell count), and calcium levels are not direct indicators of the effectiveness of TPN in this context.

3. When should a newborn transition to whole milk according to dietary teaching for breastfeeding parents?

• A. 6 months
• B. 8 months
• C. 10 months
• D. 12 months

Correct answer: D

Rationale: Breast milk or formula should be the primary source of nutrition for infants up to around 1 year of age. The transition to whole cow's milk is recommended at 12 months of age, not earlier. Introducing whole milk before 12 months can lead to digestive issues and nutrient deficiencies. Therefore, choices A, B, and C are incorrect as they suggest transitioning to whole milk before the recommended age of 12 months.

4. What is the most common type of kidney stone?

• A. Cystine
• B. Calcium
• C. Struvite
• D. Uric acid

Correct answer: B

Rationale: The most common type of kidney stone is calcium-based, specifically calcium oxalate. This is usually due to high calcium levels in the urine, which can be caused by dietary factors or certain metabolic disorders. Cystine stones, on the other hand, are less common and occur in individuals with a hereditary disorder leading to excessive excretion of certain amino acids. Struvite stones are often formed in response to an infection. Uric acid stones may occur in individuals who do not consume sufficient fluids or who lose too much fluid, among other factors. Therefore, while all these substances can form stones in the kidneys, calcium stones are the most common.

5. What should be recommended to help prevent early childhood caries (ECC) in infants?

• A. Avoid giving the infant nighttime bottles
• B. Have the infant drink pasteurized skim milk
• C. Feed the infant iron-rich foods
• D. Give the infant fruit juice to drink

Correct answer: A

Rationale: The correct answer is 'A: Avoid giving the infant nighttime bottles' because prolonged exposure to sugars in milk during the night can lead to caries. Options 'B: Have the infant drink pasteurized skim milk' and 'D: Give the infant fruit juice to drink' are not recommended as they contain sugars that can cause cavities, especially in infants. Option 'C: Feed the infant iron-rich foods' is incorrect because while a balanced diet is important, iron-rich foods do not directly prevent caries development.

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