Nursing Elites

1. One of the most common factors that compromise the vitamin D status of older adults, particularly those living in assisted living communities is _____.

• A. decreased intake of fruits and vegetables
• B. lack of physical activity
• C. malabsorption due to atrophic gastritis
• D. lack of exposure to sunlight

Correct answer: D

Rationale: The correct answer is 'D: lack of exposure to sunlight.' Older adults, especially those in assisted living communities, are at risk of vitamin D deficiency due to spending most of their time indoors, which reduces their exposure to sunlight. Sunlight is essential for the body to produce vitamin D. Choices A, B, and C are less likely to be major factors in compromising vitamin D status. While a decreased intake of fruits and vegetables and lack of physical activity can impact overall health, they are not as directly related to vitamin D status. Malabsorption due to atrophic gastritis may affect the absorption of certain nutrients, but vitamin D synthesis primarily depends on sunlight exposure.

2. Which set of guidelines is intended to assess nutrient adequacy or plan intakes of population groups, not individuals?

• A. Old Recommended Dietary Allowances (RDA)
• B. Estimated Average Requirement (EAR)
• C. New Recommended Dietary Allowances (RDA)
• D. Tolerable Upper Intake Level (UL)

Correct answer: B

Rationale: The Estimated Average Requirement (EAR) is specifically designed to assess nutrient adequacy or plan intakes for population groups, not for individuals. The Old and New Recommended Dietary Allowances (RDA) are meant for individuals, not groups, as they provide guidelines for specific nutrient intake levels for healthy individuals. The Tolerable Upper Intake Level (UL) is used to set the highest level of nutrient intake that is likely to pose no risk of adverse health effects for most individuals in a group, which is different from assessing nutrient adequacy for groups.

3. An advance directive known as a durable power of attorney involves appointing another person called a(n) _____ to act as the decision maker in the event of the patient's incapacitation.

• A. witness
• B. primary caregiver
• C. health care agent
• D. state proxy

Correct answer: C

Rationale: The correct answer is 'health care agent.' A health care agent is appointed through a durable power of attorney to make medical decisions on behalf of a patient who becomes incapacitated. The term 'witness' (choice A) is incorrect because a witness only observes the signing of the directive and does not make decisions. 'Primary caregiver' (choice B) is also incorrect as they may provide care but are not necessarily legally empowered to make decisions. 'State proxy' (choice D) is not commonly used in the context of advance directives or health care decision making, making it an incorrect choice.

4. Each of the following accurately describes features of MyPlate except one. Which one is the exception?

• A. MyPlate replaces the well-known food guide, MyPyramid.
• B. The interactive website is intended to help consumers apply personalized dietary guidance.
• C. Whereas MyPyramid was more specific in many areas, MyPlate provides more general information.
• D. Foods providing similar types of nutrients are grouped together and emphasize proportionality of food selections.

Correct answer: C

Rationale: The correct answer is C because MyPlate actually provides more specific guidance compared to MyPyramid. MyPlate was designed to simplify the dietary recommendations for consumers by focusing on a visual representation of a plate divided into food groups, making it easier to understand and apply. Choices A, B, and D accurately describe features of MyPlate: replacing MyPyramid, providing personalized dietary guidance through an interactive website, and grouping foods with similar nutrients while emphasizing proportionality of food selections.

5. Which statement about essential nutrients should the nurse include?

• A. Fat-containing foods can help to decrease triglyceride levels.
• B. Animal sources of protein contain 20 essential amino acids.
• C. Carbohydrates are the primary source of fuel for muscles and the brain.
• D. High-fiber foods are a good source of energy.

Correct answer: C

Rationale: The correct answer is C because carbohydrates are indeed the primary source of fuel for muscles and the brain. Choice A is incorrect because while certain fats are essential, they do not help decrease triglyceride levels. Choice B is incorrect because animal sources of protein do not contain all 20 essential amino acids. Choice D is incorrect because although high-fiber foods are important for digestion and overall health, they are not a direct source of energy.

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