Nursing Elites

1. Which adolescent student lunch, evaluated by the school nurse, is the least nutritious?

• A. Ham sandwich, apple, and milk
• B. Hamburger, fries, and soft drink
• C. Macaroni and cheese, green beans, and peaches
• D. Meatloaf, broccoli, and pear slices

Correct answer: B

Rationale: The correct answer is B: Hamburger, fries, and soft drink. This meal is considered the least nutritious among the options provided due to its high content of unhealthy fats, processed carbohydrates, and added sugars, which lack essential nutrients. On the other hand, choice A: Ham sandwich, apple, and milk, offers a balanced meal with protein, fiber, vitamins, and calcium. Choice C: Macaroni and cheese, green beans, and peaches, provides a mixture of carbohydrates, vegetables, and fruits. Choice D: Meatloaf, broccoli, and pear slices, includes protein, fiber, and vitamins. Thus, all choices except B provide a more balanced and nutritious meal.

2. Which suggestion is most appropriate to increase calorie intake for a patient with stomach cancer, aiming to prevent weight loss and wasting?

• A. Replace whole fat milk with skim milk or water
• B. Avoid peanut butter and other nuts
• C. Choose high-fat meat instead of lean meat
• D. Limit alcohol intake to two drinks per day

Correct answer: C

Rationale: The correct answer is C: Choose high-fat meat instead of lean meat. High-fat meats are more calorie-dense than lean meats, which makes them a good choice for increasing calorie intake. This is crucial for patients with stomach cancer who want to avoid weight loss and wasting. Choice A is incorrect because skim milk or water contains fewer calories than whole fat milk. Choice B is also incorrect because peanut butter and nuts are high in calories and therefore should not be avoided when trying to increase calorie intake. Finally, choice D is not a good suggestion to increase calorie intake as alcohol does not provide the necessary nutrients needed for a balanced diet. In fact, excessive alcohol can harm the liver and other organs, and it's not a reliable source of calories.

3. A client with frequent kidney stones is receiving dietary teaching from a nurse. Which of the following instructions should the nurse include?

• A. Limit your intake of dairy products.
• B. Increase your consumption of protein-rich foods.
• C. Avoid eating tree nuts, such as almonds.
• D. Take a vitamin C supplement twice daily.

Correct answer: A

Rationale: The correct answer is to instruct the client to limit their intake of dairy products. Dairy products are high in calcium and can contribute to kidney stone formation in susceptible individuals. Increasing protein intake may lead to higher excretion of calcium, which can exacerbate kidney stone formation. While tree nuts are high in oxalates, which can contribute to kidney stone formation, it is not the primary concern in this case. Vitamin C supplements can increase oxalate levels in the urine, potentially increasing the risk of kidney stone formation, so it should not be recommended.

4. A nurse is developing a program about strategies to prevent foodborne illnesses for a community group. The nurse should plan to include which of the following recommendations? (Select one that does not apply).

• A. Keep cold food temperatures below 4.4�C (40�F).
• B. Reheat leftovers before eating.
• C. Wash raw vegetables thoroughly in clean water.
• D. Keep cooked foods at 48.9�C (120�F).

Correct answer: D

Rationale: The correct answer is to keep cooked foods at 48.9�C (120�F). This temperature is too low to keep cooked foods safe from bacterial growth. The ideal temperature to keep cooked foods safe is above 60�C (140�F). Choices A, B, and C are all important strategies to prevent foodborne illnesses. Keeping cold food temperatures below 4.4�C (40�F) helps prevent bacterial growth, reheating leftovers before eating kills any bacteria that may have grown during storage, and washing raw vegetables thoroughly in clean water helps remove dirt and bacteria.

5. Select all that apply. You are interested in learning about the effect of eating diet soft drinks on your health. Your internet search leads you to a website with the ending .com, which tells you that diet soft drinks contain sugar alcohols that can cause harm. Which of the following actions are logical?

• A. notice if there are any ads on the page that suggest conflicts of interest
• B. read about consuming diet soft drinks in the dietary guidelines for Americans
• C. visit a more credible website and compare information
• D. all of the above

Correct answer: D

Rationale: Logical steps include evaluating the credibility of the website, reading official guidelines, comparing information from credible sources, and verifying the author's qualifications.

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