Nursing Elites

1. During nutritional counseling, what is the most important step to take?

• A. Consult the patient's family
• B. Formulate a sample diet plan before presenting it to the patient
• C. Include members of the dental team in the dietary formulation
• D. Include the patient in the formulation of the dietary plan

Correct answer: D

Rationale: During nutritional counseling, the most important step is to include the patient in the formulation of the dietary plan. This ensures their active involvement, understanding, and commitment to the plan, leading to better compliance and success in achieving nutritional goals. Consulting the patient's family (Choice A) may be helpful but should not replace involving the patient directly. Formulating a sample diet plan before presenting it to the patient (Choice B) may not align with the patient's preferences or needs. Including members of the dental team in the dietary formulation (Choice C) may not be necessary unless specific dental concerns need to be addressed.

2. A client scheduled for hysterosalpingography needs health teaching before the procedure. The nurse is correct in telling the patient that:

• A. She needs to void prior to the procedure
• B. A full bladder is needed prior to the procedure
• C. Painful sensation is felt as the needle is inserted
• D. Flushing sensation is felt as the dye in injected

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

3. A healthcare professional has just inserted an NG tube for a client who is to start enteral tube feedings. Which of the following actions should the healthcare professional take to verify tube placement?

• A. Measure the tube length.
• B. Obtain an abdominal x-ray.
• C. Flush the tube with 20 mL of water.
• D. Auscultate the client’s lungs.

Correct answer: B

Rationale: Obtaining an abdominal x-ray is the most accurate method to verify the correct placement of an NG tube. Measuring the tube length is not a reliable method to confirm placement as it may vary among individuals. Flushing the tube with water and auscultating the client's lungs are not definitive methods to ensure proper NG tube placement.

4. A nurse is providing teaching to a group of parents of newborns who are planning to formula feed. Which of the following statements by a parent indicates a need for further teaching?

• A. "I will give formula to my baby at room temperature."
• B. "I will ensure my baby's feeds last 10 to 15 minutes."
• C. "I will burp my baby halfway through each feeding."
• D. "I will watch for signs my baby is full and stop the feeding."

Correct answer: B

Rationale: The correct answer is, "I will ensure my baby's feeds last 10 to 15 minutes." This statement indicates a need for further teaching because it suggests a strict time limit for feedings, which may not be appropriate for a newborn. Newborns should be allowed to feed as long as they want, typically around 20-30 minutes per breast if breastfeeding, or on-demand with formula. Choices A, C, and D demonstrate proper feeding practices such as feeding at room temperature, burping halfway through each feeding, and watching for signs of fullness to stop the feeding, which are all appropriate responses by a parent of a formula-fed newborn.

5. Which set of guidelines is intended to assess nutrient adequacy or plan intake of a population group, not individuals?

• A. RDA
• B. EAR
• C. DRA
• D. UL

Correct answer: B

Rationale: The Estimated Average Requirement (EAR) is the correct choice because it is specifically designed to assess the nutrient adequacy of population groups, not individuals. The Recommended Dietary Allowance (RDA) (choice A) is the average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%-98%) healthy individuals in a particular life stage and gender group. The Dietary Reference Intake (DRI) (choice C) includes the EAR, RDA, Adequate Intake (AI), and UL, making it a broader set of nutrient reference values. The Tolerable Upper Intake Level (UL) (choice D) is the highest average daily nutrient intake level that is likely to pose no risk of adverse health effects to almost all individuals in the general population.

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