Nursing Elites

1. What goal should an overweight woman include in her lifestyle for a healthy pregnancy?

• A. Aim to lose 11 to 20 pounds during pregnancy
• B. Increase protein intake to 35% of total calories
• C. Delay weight loss until after pregnancy
• D. Increase daily energy intake by 550 calories

Correct answer: C

Rationale: The healthiest approach for an overweight pregnant woman is to delay weight loss until after pregnancy. During pregnancy, the body needs sufficient nutrition and energy to support the growth and development of the baby. Attempting to lose weight during pregnancy, especially significant amounts, may compromise the health of both the mother and the baby. Increasing protein intake to 35% of total calories or energy intake by 550 calories per day without professional guidance may lead to an unbalanced diet, which is not optimal for pregnancy. The focus should be on maintaining a balanced, nutrient-rich diet and appropriate weight gain during pregnancy.

2. In PEM, which condition is characterized by symptoms such as muscle weakness, hanging skin, delayed tooth eruption, and changes in saliva?

• A. Marasmus
• B. Kwashiorkor
• C. Anemia
• D. Noma

Correct answer: A

Rationale: The correct answer is Marasmus. Marasmus is a severe form of protein-energy malnutrition (PEM) that leads to muscle wasting, hanging skin, delayed growth, and changes in saliva. These symptoms are commonly seen in vulnerable populations such as children, homeless individuals, older adults, and substance abusers. Kwashiorkor, on the other hand, is characterized by edema, a distended belly, and skin lesions. Anemia is a condition characterized by a low red blood cell count, leading to fatigue and weakness. Noma is a severe infection affecting the face, particularly the mouth and jaw area.

3. Each statement is true of rickets, except one. Which is the exception?

• A. Rickets is being diagnosed more frequently in the United States.
• B. Rickets is caused by vitamin C deficiency.
• C. Tachetic deformities such as bow legs or knock-knees develop.
• D. A narrow and distorted chest occurs.

Correct answer: B

Rationale: Rickets is caused by vitamin D deficiency, not vitamin C deficiency. It usually occurs in children who are 1 to 3 years old. The name rickets came from the word 'wrikken,' meaning 'to bend or twist.' Common manifestations of rickets include tachetic deformities like bow legs or knock-knees, a narrow and distorted chest, and failure of the epiphyses of bones to develop normally, resulting in twisted and warped bones. While the diagnosis of rickets may be increasing in the United States, it is not caused by a lack of vitamin C.

4. The purpose of the health history is to identify health-related considerations and medications that may cause nutritional risk. Many medications, such as prednisone, have drug-nutrient interactions that can influence nutrient needs.

• 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: A

Rationale: Both statements are true. The health history aims to uncover health-related factors that could pose nutritional risks, including medications like prednisone that may have interactions affecting nutrient requirements. Choice B is incorrect as both statements are accurate, emphasizing the significance of health history in assessing nutritional concerns.

5. A nurse is providing MyPlate education to a client newly diagnosed with diabetes mellitus. Which plate chosen by the client indicates the teaching was effective, according to the MyPlate guidelines?

• A. 1/2 of the plate is filled with carbohydrate foods, 1/4 filled with protein foods, and 1/4 filled with fruits and vegetables
• B. 1/2 of the plate is filled with protein foods, 1/4 filled with carbohydrates, and 1/4 filled with non-starchy vegetables
• C. 1/2 of the plate is filled with carbohydrates, 1/4 filled with protein foods, and 1/4 filled with non-starchy vegetables
• D. 1/2 of the plate is filled with non-starchy vegetables, 1/4 filled with protein foods, and 1/4 filled with carbohydrate foods

Correct answer: D

Rationale: The correct answer is D. This option reflects the MyPlate guidelines for managing diabetes effectively. In diabetes management, it is essential to focus on non-starchy vegetables, appropriate protein portions, and controlled carbohydrate intake. Option A places too much emphasis on carbohydrates, which may not be suitable for diabetes. Option B swaps the proportions of protein and carbohydrates, which is not in line with the recommended distribution. Option C places too much emphasis on carbohydrates and lacks the emphasis on non-starchy vegetables, making it less suitable for diabetes management.

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