Nursing Elites

1. The recommended daily fluid intake of patients maintained using hemodialysis is:

• A. 150 mL plus the volume of urinary output
• B. 500 mL plus the volume of urinary output
• C. 1000 mL plus the volume of urinary output
• D. 1500 mL plus the volume of urinary output

Correct answer: C

Rationale: The correct answer is C: 1000 mL plus the volume of urinary output. Fluid intake is typically restricted in hemodialysis patients to prevent fluid overload. The recommended daily fluid intake for these patients is 1000 mL plus any urinary output. Choice A (150 mL plus the volume of urinary output) is too low and would not provide enough fluid for these patients. Choice B (500 mL plus the volume of urinary output) is also insufficient. Choice D (1500 mL plus the volume of urinary output) is too high and may lead to fluid overload in hemodialysis patients.

2. Which of the following provides greater flexibility, better balance, more endurance, and overall better health and greater longevity for older adults?

• A. Eating balanced meals
• B. Not smoking or drinking alcohol
• C. Daily physical activity
• D. Increased intake of calcium and iron

Correct answer: C

Rationale: The correct answer is C: Daily physical activity. Daily physical activity contributes to better flexibility, balance, endurance, and overall health, helping older adults maintain independence and reduce the risk of chronic diseases. Choices A, B, and D, although important for overall health, do not specifically address the benefits of greater flexibility, better balance, more endurance, and greater longevity associated with daily physical activity.

3. 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.

4. A pregnant woman has applied to use WIC services to supplement her food intake. The WIC program would provide vouchers for _____ in this situation.

• A. lean beef
• B. fruit-flavored yogurt
• C. whole grain bread
• D. refried beans

Correct answer: C

Rationale: The correct answer is C: whole grain bread. The WIC program aims to provide nutritious foods to support a healthy diet during pregnancy. Whole grain bread is a good source of fiber and essential nutrients. Choice A, lean beef, is a protein source but may not be as versatile as whole grain bread in providing a variety of nutrients essential during pregnancy. Choice B, fruit-flavored yogurt, may contain added sugars and may not offer the same level of essential nutrients as whole grain bread. Choice D, refried beans, is a good source of protein and fiber, but whole grain bread is often a staple recommended in pregnancy for its nutritional benefits.

5. A client is being taught by a nurse about adding more fiber to the diet. Which of the following foods has the highest fiber content?

• A. 1 cup cooked sweet potato
• B. 1 slice rye toast
• C. 1 cup raw watermelon
• D. 1 oz cashews

Correct answer: D

Rationale: The correct answer is D, 1 oz of cashews. Cashews have a higher fiber content compared to sweet potato, rye toast, and watermelon. While sweet potatoes and rye toast contain fiber, cashews have a higher concentration, making them a better choice for increasing fiber intake. Watermelon, on the other hand, is low in fiber compared to the other options provided.

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