Nursing Elites

1. The most energy-rich nutrient is:

• A. carb
• B. fat
• C. protein
• D. water

Correct answer: B

Rationale: Fat provides 9 kcal per gram, making it the most energy-rich nutrient compared to carbohydrates and proteins, which provide 4 kcal per gram.

2. 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.

3. Which is NOT a prudent recommendation for a menopausal patient?

• A. Supplement calcium and vitamin D slightly beyond upper intake level
• B. Encourage lean protein and regular exercise
• C. Avoid alcohol if xerostomia is present
• D. Consumption of 90 mg daily of isoflavones in soy products helps to increase bone mass

Correct answer: A

Rationale: Excessive supplementation of calcium and vitamin D beyond the upper intake level is not recommended unless under medical supervision, as it can cause adverse health effects.

4. A community health nurse is conducting a class on what to expect during pregnancy. What instruction should the nurse include on weight gain?

• A. Failure to obtain the required weight gain during pregnancy will increase the risk of preterm birth.
• B. An obese client should not gain as much weight as a client with a normal body mass index.
• C. A client with a normal body mass index should plan on gaining 50 pounds.
• D. Clients do not need to eat for two when they are pregnant.

Correct answer: A

Rationale: Adequate weight gain during pregnancy is essential as failure to obtain the required weight gain can increase the risk of preterm birth. Choice B is incorrect because it is important for obese clients to gain an appropriate amount of weight during pregnancy, not the same as those with a normal body mass index. Choice C is incorrect as gaining 50 pounds for a client with a normal body mass index is excessive. Choice D is incorrect as the common saying 'eating for two' during pregnancy is a misconception; pregnant individuals do not need to double their caloric intake.

5. When assessing Richard for chest percussion or chest vibration and postural drainage, Mario would focus on the following EXCEPT:

• A. Amount of food and fluid taken during the last meal before treatment
• B. Respiratory rate, breath sounds, and location of congestion
• C. Teaching the client's relatives to perform the procedure
• D. Doctor's order regarding position restrictions and client's tolerance for lying flat

Correct answer: B

Rationale: The correct answer is B because when assessing Richard for chest percussion or chest vibration and postural drainage, Mario would focus on various aspects such as the amount of food and fluid taken before treatment to prevent complications during the procedure, teaching the client's relatives to perform the procedure correctly, and following the doctor's orders regarding position restrictions and the client's tolerance for lying flat. Respiratory rate, breath sounds, and location of congestion would be assessed during the procedure itself, not as part of the pre-assessment.

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