Nursing Elites

1. Mr. Bradley has been advised to limit his dairy product intake. What principle regarding fluid intake should be followed?

• A. Gelatin, soups, fruit ices, and frozen fruit bars contribute to your fluid intake
• B. Drink milk in moderation
• C. Increase fiber intake
• D. Limit protein intake

Correct answer: A

Rationale: For patients with kidney disease, it's important to manage fluid intake from all sources, including foods like gelatin and soups, which can contribute to fluid overload.

2. You are on duty in the medical ward. You were asked to check the narcotics cabinet. You found out that what is on record does not tally with the drugs used. What will you do first?

• A. Write an incident report and refer the matter to the nursing director
• B. Keep your findings to yourself
• C. Report the matter to your supervisor
• D. Find out from the endorsement any patient who might have been given narcotics

Correct answer: C

Rationale: In this situation, the first step should be to report the matter to your supervisor. It is essential to notify the appropriate authority immediately to address the discrepancy in the narcotics cabinet. Choice A is not the first step as reporting to the nursing director should follow after informing the supervisor. Keeping the findings to yourself (Choice B) is not appropriate as it may jeopardize patient safety and is against ethical standards. While finding out which patient received narcotics (Choice D) is important, it is not the immediate action to take in this scenario.

3. What is the procedure called when direct observations are used to generate an estimate of a client's current food intake?

• A. Food diary
• B. 24-hour recall
• C. Kilocalorie count
• D. Nutrient surveillance record

Correct answer: C

Rationale: A kilocalorie count is the correct answer as it involves directly observing a client's food intake, which is often used in hospitals to accurately assess nutritional intake and ensure it meets dietary requirements. A food diary (Choice A) is typically self-reported by the client and not directly observed. A 24-hour recall (Choice B) is also usually self-reported and relies on a client's memory of the past 24 hours, which can be unreliable. A nutrient surveillance record (Choice D) is a broader term for tracking nutrient intake in a population and is not specific to the direct observation of an individual's food intake.

4. An essential nutrient must:

• A. be eaten every day
• B. be obtained by the diet
• C. be water soluble
• D. be eaten at every meal

Correct answer: B

Rationale: The correct answer is B: 'be obtained by the diet.' Essential nutrients are those that the body cannot synthesize in sufficient quantities and must therefore be obtained through the diet. Choice A is incorrect because not all essential nutrients need to be consumed daily; the frequency of consumption varies. Choice C is incorrect because not all essential nutrients are water-soluble; they can be water-soluble or fat-soluble. Choice D is incorrect because essential nutrients do not need to be consumed at every meal, but rather need to be included in the overall diet regularly.

5. A nurse is caring for an antepartum client who has iron-deficiency anemia. When teaching the client about nutrition, the nurse should emphasize the need for an increased intake of which of the following foods?

• A. Milk and cheese
• B. Red meat and organ meat
• C. Fresh fruits
• D. Whole grain breads

Correct answer: B

Rationale: The correct answer is red meat and organ meat. These foods are rich sources of heme iron, which is more easily absorbed by the body compared to non-heme iron found in plant-based foods. Red meat and organ meat can significantly help in increasing the iron levels in individuals with iron-deficiency anemia, especially in antepartum clients. Fresh fruits, while nutritious, do not provide high amounts of iron. Milk and cheese are not the best sources of iron for individuals with iron-deficiency anemia. Whole grain breads also do not contain as much bioavailable iron as red meat and organ meat.

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