Nursing Elites

1. Fat-soluble vitamins are different from water-soluble vitamins because the body is able to store only small amounts of fat-soluble vitamins.

• A. Both the statement and the reason are correct and related.
• B. Both the statement and the reason are correct but are not related.
• C. The statement is correct, but the reason is not correct.
• D. The statement is not correct, but the reason is correct.

Correct answer: C

Rationale: The statement is correct, but the reason is not correct. A major difference between fat-soluble and water-soluble vitamins is that the body is able to store larger amounts of fat-soluble vitamins. Vitamins A and D are stored for long periods; therefore, minor shortages might not be identified until drastic depletion has occurred. Observable signs and symptoms of a dietary deficiency are often not identified until they are in an advanced state. Water-soluble vitamins, on the other hand, are not stored in the body and are excreted in the urine if taken in excess, making it harder to reach toxic levels.

2. After ileostomy, which of the following condition is NOT expected?

• A. Increased weight
• B. Irritation of skin around the stoma
• C. Liquid stool
• D. Establishment of regular bowel movement

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 nurse is providing dietary teaching for a client who has just learned that she has type 2 diabetes mellitus. The nurse should explain that which of the following sweeteners will add calories to the client's carbohydrate count?

• A. Sorbitol
• B. Sucralose
• C. Aspartame
• D. Acesulfame potassium

Correct answer: A

Rationale: Sorbitol is a sweetener that will add calories to the client's carbohydrate count. It is a sugar alcohol that provides about 2.6 calories per gram. Sucralose, aspartame, and acesulfame potassium are all non-nutritive sweeteners that do not contribute significant calories to the diet. Sucralose is about 600 times sweeter than sucrose but does not add calories. Aspartame is a low-calorie sweetener that is approximately 200 times sweeter than sucrose, and acesulfame potassium is a calorie-free sweetener.

4. To follow a healthy diet, a person should be sure that:

• A. 20-35% of the total carbs eaten should be made up of fiber
• B. 45-65% of the total carbs eaten should be made up of fiber
• C. 45-65% of the total fiber eaten should be made up of soluble fiber
• D. 45-65% of the total calories eaten should be made up of carbs

Correct answer: D

Rationale: The Acceptable Macronutrient Distribution Range (AMDR) suggests that 45-65% of total daily calories should come from carbohydrates.

5. The nurse is working with a patient who recently had a stroke. The patient frequently chokes and coughs when eating and is having difficulty feeding herself. What is the best way to ensure adequate nutrition?

• A. to have an aide feed her at each meal
• B. to ask a family member to assist during meals
• C. to provide tube feedings for the patient
• D. to initiate TPN for the patient

Correct answer: C

Rationale: The best way to ensure adequate nutrition for a stroke patient who frequently chokes and coughs when eating and has difficulty feeding herself is to provide tube feedings. Tube feedings are a safe and effective method to deliver nutrition directly to the stomach or intestines, bypassing the swallowing mechanism, reducing the risk of aspiration. Having an aide feed her each meal (choice A) may not address the underlying issue of swallowing difficulty and aspiration risk. Asking a family member to be present at each meal (choice B) does not provide a definitive solution to the patient's nutritional needs. Placing the patient on total parenteral nutrition (TPN) (choice D) is a more invasive and typically reserved for patients who cannot tolerate enteral feedings or have non-functional gastrointestinal tracts.

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