Nursing Elites

1. What is the best dietary advice for a patient with iron-deficiency anemia?

• A. Increase dairy consumption
• B. Increase vitamin C intake
• C. Reduce red meat consumption
• D. Increase fiber intake

Correct answer: B

Rationale: The best dietary advice for a patient with iron-deficiency anemia is to increase vitamin C intake. Vitamin C enhances the absorption of non-heme iron, which can help improve iron-deficiency anemia. Choices A, C, and D are not the best options for this condition. Increasing dairy consumption (Choice A) may not directly address the iron deficiency. Reducing red meat consumption (Choice C) may limit heme iron intake, which is easily absorbed by the body. Increasing fiber intake (Choice D) is generally beneficial but is not specifically recommended as the top advice for iron-deficiency anemia.

2. 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.

3. A nurse is caring for four clients. The nurse should plan to administer total parenteral nutrition for which of the following clients?

• A. A client who is postoperative following a laminectomy and is receiving IV PCA
• B. A client who has dysphagia and does not recognize his family
• C. A client who has COPD and is going home with oxygen
• D. A client who has colon cancer and will undergo a hemicolectomy

Correct answer: D

Rationale: Total parenteral nutrition (TPN) is essential for clients undergoing significant surgical procedures like a hemicolectomy to ensure they receive adequate nutrition when oral intake is not possible. Choices A, B, and C do not typically require TPN. Choice A is managing postoperative pain with IV PCA, choice B is likely to need alternative feeding methods due to dysphagia, and choice C is going home with oxygen for COPD management, which does not directly relate to the need for TPN.

4. Because of increasing cases of fluorosis, low levels of fluoride are added to commercial infant formula. Breast milk provides low levels of fluoride.

• A. Both statements are true
• B. Both statements are false
• C. The first statement is true; the second is false
• D. The first statement is false; the second is true

Correct answer: D

Rationale: The first statement is false; fluoride is not added to infant formulas due to the risk of fluorosis. The second statement is true; breast milk contains low levels of fluoride.

5. The ideal time to begin taking folate to prevent neural tube defects is:

• A. Before conception
• B. Once pregnancy begins
• C. At 6 weeks
• D. Upon completion of the first trimester

Correct answer: A

Rationale: Folate is crucial before conception to prevent neural tube defects. Neural tube development occurs early in pregnancy, often before a woman knows she is pregnant.

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