Nursing Elites

1. Which dietary recommendation is most appropriate for a patient with gout?

• A. Increase protein intake
• B. Reduce carbohydrate intake
• C. Avoid purine-rich foods
• D. Increase calcium intake

Correct answer: C

Rationale: The most appropriate dietary recommendation for a patient with gout is to avoid purine-rich foods. Purine-rich foods such as red meat and shellfish can lead to increased uric acid levels in the body, triggering gout flare-ups. Increasing protein intake (Choice A) is not recommended as some high-protein foods are also high in purines. Reducing carbohydrate intake (Choice B) and increasing calcium intake (Choice D) are not directly related to managing gout symptoms.

2. A client is being prepared for placement of a catheter for total parenteral nutrition. Which of the following access sites should be planned for catheter insertion?

• A. Left antecubital vein
• B. Right subclavian vein
• C. Right femoral artery
• D. Left arm radial artery

Correct answer: B

Rationale: The correct answer is the Right subclavian vein. When preparing a client for placement of a catheter for total parenteral nutrition, the preferred access site for catheter insertion is the subclavian vein due to its large size, central location, and lower risk of infection compared to peripheral veins. The other options provided (Left antecubital vein, Right femoral artery, and Left arm radial artery) are not suitable access sites for central venous catheter insertion for total parenteral nutrition.

3. What laboratory value would be considered a high-risk measure for coronary heart disease assessment?

• A. triglycerides > 150 mg/dL
• B. BMI > 31
• C. LDL cholesterol < 128 mg/dL
• D. blood pressure of 128/82 mmHg

Correct answer: B

Rationale: The correct answer is B: BMI > 31. A BMI over 31 is considered a high-risk factor for coronary heart disease as it indicates obesity, which is strongly linked to cardiovascular issues. Triglycerides > 150 mg/dL (choice A) can contribute to heart disease risk but are not as specific as BMI in assessing overall risk. LDL cholesterol < 128 mg/dL (choice C) is actually a desirable level, indicating lower risk. A blood pressure of 128/82 mmHg (choice D) is within normal range and not a high-risk measure specifically for coronary heart disease.

4. A healthcare provider is providing teaching about nutrition to a group of clients. The healthcare provider should include that which of the following foods contains the highest level of thiamine per serving?

• A. 1 hard-boiled egg
• B. 1 cup dried pears
• C. 1 cup whole grain wheat flour
• D. 1 cup Brussels sprouts

Correct answer: C

Rationale: Whole grain wheat flour contains the highest level of thiamine per serving compared to the other options provided. Thiamine, also known as Vitamin B1, is essential for energy metabolism. While eggs, dried pears, and Brussels sprouts are nutritious foods, they do not contain as high a level of thiamine as whole grain wheat flour. Therefore, the correct choice is whole grain wheat flour in this case.

5. Generally, patients who wear dentures have reduced masticatory efficiency. Mandibular implant-supported dentures can have positive effects on the clinical aspects of mastication and swallowing.

• 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: A

Rationale: Both statements are true. Patients who wear dentures typically experience reduced masticatory efficiency. Mandibular implant-supported dentures are known to have positive effects on the clinical aspects of mastication and swallowing, significantly improving chewing function. Option A is correct because both statements align with these facts. Option B is incorrect as both statements are true. Option C is incorrect as the second statement is also true. Option D is incorrect as the first statement is true.

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