Nursing Elites

1. Each of the following accurately describes aspects of the dietary reference intakes (DRIs) published by the Food and Nutrition Board of the Institute of Medicine (IOM) except one. Which one is the exception?

• A. The DRIs replace the older recommended daily allowances.
• B. Current DRIs attempt to estimate required nutrients to improve long-term health.
• C. DRIs specifically address individuals whose requirements are affected by a disease state.
• D. The DRIs attempt to establish maximum safe levels of tolerance for nutrients.

Correct answer: C

Rationale: The correct answer is C. DRIs do not specifically address individuals with disease states; they are intended for the general healthy population. Choice A is correct because DRIs indeed replace the older recommended daily allowances. Choice B is correct as current DRIs aim to estimate required nutrients to enhance long-term health. Choice D is accurate as DRIs also attempt to establish maximum safe levels of tolerance for nutrients.

2. A nurse is caring for a client who has a body mass index (BMI) of 30. Four weeks after nutritional counseling, which of the following evaluation findings indicates the plan of care was followed?

• A. BMI of 25
• B. Weight gain of 1.8 kg
• C. BMI of 33
• D. Weight loss of 2.7 kg

Correct answer: D

Rationale: A weight loss of 2.7 kg in four weeks indicates effective adherence to a nutritional plan aimed at reducing body mass index (BMI), moving towards a healthier weight. Choices A, B, and C are incorrect because a decrease in weight, as shown in choice D, is the desired outcome when managing a client with a BMI of 30 to reach a healthier range.

3. A nurse is teaching about nutrition to a client who has a new diagnosis of chronic kidney disease. Which of the following recommendations should the nurse include in the teaching?

• A. Increase phosphorus intake
• B. Limit calcium intake
• C. Limit protein intake
• D. Increase potassium intake

Correct answer: C

Rationale: The correct recommendation for a client with chronic kidney disease is to limit protein intake. Excessive protein consumption can strain the kidneys as they work to eliminate waste products from protein metabolism. This can worsen kidney function in individuals with chronic kidney disease. Therefore, limiting protein intake is crucial in managing this condition. Choices A, B, and D are incorrect. Increasing phosphorus intake can be harmful in kidney disease as it can lead to mineral imbalances. Limiting calcium intake is not typically necessary unless the client has specific complications. Increasing potassium intake may also be inappropriate as potassium levels can be affected in kidney disease.

4. A client who is 2 days postoperative following abdominal surgery is about to progress from a clear liquid diet to full liquids. Which of the following items should the nurse tell the client he may now request to have on his meal tray?

• A. Cranberry juice
• B. Flavored gelatin
• C. Skim milk
• D. Chicken broth

Correct answer: A

Rationale: Cranberry juice is an appropriate choice for a client transitioning from a clear liquid diet to full liquids post abdominal surgery. It provides hydration and some essential nutrients. Flavored gelatin is usually allowed on a clear liquid diet and may not be suitable for a full liquids phase. Skim milk and chicken broth are typically introduced in a later stage of the diet progression, closer to a soft diet, due to their higher protein and fat content.

5. Characteristics of type two diabetes include all of the following except:

• A. insulin resistance
• B. blood glucose levels that rise too high
• C. blood insulin levels that rise too high
• D. rapid destruction of the pancreas

Correct answer: D

Rationale: Type 2 diabetes is characterized by insulin resistance, high blood glucose levels, and high blood insulin levels. Rapid destruction of the pancreas is not a feature of this condition. The destruction of pancreatic beta cells is more commonly associated with type 1 diabetes, not type 2 diabetes. Therefore, option D is the correct answer. Options A, B, and C are all characteristic features of type 2 diabetes, making them incorrect choices.

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