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. A nurse is providing discharge teaching about food choices to a client who has hypokalemia. Which of the following foods should the nurse identify as the best source of potassium?

• A. 1 cup grapes
• B. 1 cup shredded lettuce
• C. 1 cup cooked tomatoes
• D. 1 cup apple slices

Correct answer: C

Rationale: Cooked tomatoes are high in potassium, which is crucial for maintaining normal cell function, nerve transmission, and muscle contraction, making them a suitable choice for addressing hypokalemia. Grapes, shredded lettuce, and apple slices do not contain as much potassium as cooked tomatoes, so they are not the best choice for addressing hypokalemia.

3. Select all that apply. Characteristics of the 2 main types of essential fatty acids discussed in class include:

• A. they must be supplied by the diet
• B. they can be produced by a process called dehydrogenation
• C. they are anti-inflammatory
• D. they are all polyunsaturated fatty acids

Correct answer: A

Rationale: The correct answer is A: 'they must be supplied by the diet.' Essential fatty acids, like omega-3 and omega-6, cannot be produced by the body and must be obtained through the diet. They are polyunsaturated fatty acids, playing vital roles in inflammation and cell membrane structure. Choice B is incorrect because essential fatty acids cannot be produced by dehydrogenation, a process of removing hydrogen. Choice C is incorrect as not all essential fatty acids are anti-inflammatory; some have pro-inflammatory roles. Choice D is incorrect because not all essential fatty acids are polyunsaturated; omega-9, for example, is a monounsaturated essential fatty acid.

4. Which of the following actions would be of highest priority with regards to the external shunt?

• A. Avoid taking blood pressure or blood sample from the arm with the shunt
• B. Instruct the patient not to exercise the arm with the shunt
• C. Heparinize the shunt daily
• D. Change the dressing of the shunt daily

Correct answer: C

Rationale: Heparinizing the shunt daily (choice C) is the highest priority action as it prevents the formation of blood clots that can occlude the shunt, leading to potential complications such as thrombosis. Avoiding taking blood pressure or blood samples from the arm with the shunt (choice A) is also important, but secondary to heparinizing the shunt. Similarly, instructing the patient not to exercise the arm with the shunt (choice B) can help prevent unnecessary strain on the shunt, but it is not as critical as preventing clot formation. Changing the dressing of the shunt daily (choice D) is a standard nursing care practice to prevent infection, but again, it is not as critical as ensuring the shunt remains patent through daily heparinization.

5. Which nutrient is most important for pregnant women to prevent neural tube defects?

• A. Iron
• B. Folate
• C. Calcium
• D. Vitamin D

Correct answer: B

Rationale: Folate (or folic acid) is crucial for the prevention of neural tube defects during pregnancy.

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