Nursing Elites

1. What is the procedure called when direct observations are used to generate an estimate of a client's current food intake?

• A. Food diary
• B. 24-hour recall
• C. Kilocalorie count
• D. Nutrient surveillance record

Correct answer: C

Rationale: A kilocalorie count is the correct answer as it involves directly observing a client's food intake, which is often used in hospitals to accurately assess nutritional intake and ensure it meets dietary requirements. A food diary (Choice A) is typically self-reported by the client and not directly observed. A 24-hour recall (Choice B) is also usually self-reported and relies on a client's memory of the past 24 hours, which can be unreliable. A nutrient surveillance record (Choice D) is a broader term for tracking nutrient intake in a population and is not specific to the direct observation of an individual's food intake.

2. In which of the following conditions does a person need to sit, stand, or use multiple pillows when lying down?

• A. Orthopnea
• B. Dyspnea
• C. Eupnea
• D. Apnea

Correct answer: A

Rationale: The correct answer is Orthopnea. Orthopnea is a medical condition in which a person has difficulty breathing while lying down. To alleviate this difficulty, the person may need to sit, stand, or use multiple pillows. On the other hand, Dyspnea refers to general shortness of breath which is not specifically related to the position of the body. Eupnea is the term for normal, unlabored breathing, and Apnea is a condition characterized by the cessation of breathing. Thus, none of these other choices directly relate to the need to adjust body position or use aids like multiple pillows to breathe comfortably when lying down.

3. Which enzyme initiates protein digestion in the stomach?

• A. Pepsin
• B. Salivary Amylase
• C. CCK
• D. Secretin

Correct answer: A

Rationale: Pepsin is the enzyme that initiates protein digestion in the stomach. It breaks down proteins into smaller peptides, aiding in their further digestion and absorption in the intestines. Salivary Amylase (Choice B) functions in breaking down dietary carbohydrates in the mouth, not proteins. CCK (Choice C) and Secretin (Choice D) are hormones involved in the digestion of fats and carbohydrates, not proteins. Therefore, Choices B, C, and D are incorrect in the context of protein digestion in the stomach.

4. A client with a body mass index of 28 is seeking dietary advice. Which of the following actions should the nurse take?

• A. Encourage the client to continue their current daily caloric intake.
• B. Recommend a total fiber intake of 12g per day.
• C. Advise the client to add 500 calories per day to their diet.
• D. Refer the client to a weight-loss support group.

Correct answer: D

Rationale: Referring the client to a weight-loss support group is the most appropriate action for a client with a body mass index of 28. This action can provide the necessary support, guidance, and motivation to help the client achieve their weight loss goals. Encouraging the client to continue their current daily caloric intake (Choice A) may not address the need for weight loss. Recommending a total fiber intake of 12g per day (Choice B) is important for overall health but may not directly address weight loss. Advising the client to add 500 calories per day to their diet (Choice C) would not be beneficial for weight loss in this scenario.

5. You are taking care of critically ill client and the doctor in charge calls to order a DNR (do not resuscitate) for the client. Which of the following is the appropriate action when getting DNR order over the phone?

• A. Have the registered nurse, family spokesperson, nurse supervisor and doctor sign
• B. Have 2 nurse validate the phone order, both nurses sign the order and the doctor should sign his order within 24
• C. Have the registered nurse, family and doctor sign the order
• D. Have 1 nurse take the order and sign it and have the doctor sign it within 24 hours

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

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