Nursing Elites

1. Medication for treating high blood cholesterol levels should not be used for most people unless:

• A. The patient has at least three major risk factors for coronary heart disease
• B. The patient has been experiencing symptoms of coronary heart disease for at least three months
• C. The patient's medical insurance covers prescription drugs
• D. Treatment with Therapeutic Lifestyle Changes (TLC) alone is unsuccessful after three months

Correct answer: D

Rationale: The correct answer is choice D because medication for high cholesterol is typically not considered unless Therapeutic Lifestyle Changes (TLC), which include diet and exercise, have not proven effective after a three-month period. This approach ensures that lifestyle modifications are given a fair chance to lower cholesterol levels before resorting to medication. Choice A is incorrect because the number of risk factors for coronary heart disease does not dictate when to begin medication; it is about the effectiveness of lifestyle changes. Choice B is incorrect as the duration of coronary heart disease symptoms does not determine when to start medication; the focus is on the response to TLC. Choice C is incorrect because the coverage of prescription drugs by the patient's insurance does not influence the medical decision to use medication for high cholesterol; it is based on medical necessity and effectiveness of prior interventions.

2. What sensation is used as a gauge so that patients with ileostomy can determine how often their pouch should be drained?

• A. Sensation of taste
• B. Sensation of pressure
• C. Sensation of smell
• D. Urge to defecate

Correct answer: B

Rationale: The correct answer is B: Sensation of pressure. Patients with ileostomy can determine how often their pouch should be drained by feeling the sensation of pressure. This is important as it helps prevent leakage or overflow of the pouch. The sensation of taste (choice A) and smell (choice C) are not typically used as gauges for draining the pouch in ileostomy patients. The urge to defecate (choice D) is not relevant in this context as patients with ileostomy do not pass stool through the rectum.

3. What is the most appropriate instruction to provide to the parent of a child who does not like a food item?

• A. The child should not be encouraged to try it again.
• B. The child should be offered a reward if they eat most of the food items.
• C. The child should be offered the item at least 8 times on different occasions.
• D. The child should be encouraged to eat at least 5 bites of the food item.

Correct answer: C

Rationale: The correct answer is C. Encouraging repeated exposure to the food item can help the child develop a taste for it. Option A is incorrect as it suggests avoiding encouraging the child to try the food again, which may hinder their ability to develop a liking for it. Option B is incorrect as using rewards for eating may not promote a genuine interest in the food item. Option D is incorrect because setting a specific number of bites may create pressure and negativity around mealtime, rather than fostering a positive association with the food.

4. Which foods are the biggest contributors of saturated fats consumed by Americans?

• A. Butter, coconut, and palm oils
• B. Corn oil
• C. Meat and milk
• D. Cheese, pizza, desserts, and chicken

Correct answer: D

Rationale: The correct answer is D: Cheese, pizza, desserts, and chicken. These foods are significant contributors to the intake of saturated fats in the American diet, often found in processed and fast foods. Choices A, B, and C are incorrect because while butter, coconut, and palm oils (A) are sources of saturated fats, they are not the biggest contributors in the American diet. Corn oil (B) is a source of unsaturated fats, and meat and milk (C) contain saturated fats but are not the primary contributors compared to cheese, pizza, desserts, and chicken.

5. What describes a common physical change of aging that can affect an older adult's nutrition?

• A. reduced salivary output
• B. increased gastrointestinal motility
• C. abnormal cortisol production
• D. increase in number of taste buds

Correct answer: A

Rationale: Reduced salivary output is a common physical change in aging. This can affect an older adult's nutrition by impacting chewing, swallowing, and taste perception. The decrease in saliva production can make it harder to chew and swallow food effectively, affecting the overall eating experience. Additionally, saliva plays a role in taste perception, so a reduction in salivary output can lead to alterations in how food tastes, potentially impacting an individual's appetite and food choices. Increased gastrointestinal motility (choice B) is not typically associated with aging and would not directly affect nutrition. Abnormal cortisol production (choice C) is related to hormonal changes and is not a common physical change of aging that affects nutrition. An increase in the number of taste buds (choice D) is not a typical change associated with aging and would not have a significant impact on an older adult's nutrition.

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