Nursing Elites

1. Which enzyme digests fiber in the large intestine?

• A. salivary amylase
• B. pancreatic amylase
• C. cellulase
• D. none of the above

Correct answer: D

Rationale: The correct answer is 'none of the above.' Human digestive enzymes like salivary amylase and pancreatic amylase cannot digest fiber. Instead, fiber is fermented by gut bacteria in the large intestine. Cellulase, which is an enzyme produced by some animals and microorganisms, can break down cellulose found in plants, but it is not a human digestive enzyme, making it an incorrect choice in this context.

2. A client receiving continuous enteral tube feeding reports cramping and abdominal distention. Which of the following actions should the nurse take?

• A. Check for gastric residual.
• B. Apply low intermittent suction.
• C. Increase the rate of the feeding.
• D. Request a higher-fat formula.

Correct answer: A

Rationale: When a client on continuous enteral tube feeding experiences cramping and abdominal distention, the nurse should check for gastric residual. This assessment helps determine if the client is tolerating the feeding well or if there is a potential issue such as feeding intolerance. Applying low intermittent suction, increasing the feeding rate, or requesting a higher-fat formula are not appropriate actions for addressing the reported symptoms and may exacerbate the client's discomfort or lead to further complications.

3. Which set of guidelines is intended to assess nutrient adequacy or plan intake of a population group, not individuals?

• A. RDA
• B. EAR
• C. DRA
• D. UL

Correct answer: B

Rationale: The Estimated Average Requirement (EAR) is the correct choice because it is specifically designed to assess the nutrient adequacy of population groups, not individuals. The Recommended Dietary Allowance (RDA) (choice A) is the average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%-98%) healthy individuals in a particular life stage and gender group. The Dietary Reference Intake (DRI) (choice C) includes the EAR, RDA, Adequate Intake (AI), and UL, making it a broader set of nutrient reference values. The Tolerable Upper Intake Level (UL) (choice D) is the highest average daily nutrient intake level that is likely to pose no risk of adverse health effects to almost all individuals in the general population.

4. A nurse is providing dietary teaching for a client who has just learned that she has type 2 diabetes mellitus. The nurse should explain that which of the following sweeteners will add calories to the client's carbohydrate count?

• A. Sorbitol
• B. Sucralose
• C. Aspartame
• D. Acesulfame potassium

Correct answer: A

Rationale: Sorbitol is a sweetener that will add calories to the client's carbohydrate count. It is a sugar alcohol that provides about 2.6 calories per gram. Sucralose, aspartame, and acesulfame potassium are all non-nutritive sweeteners that do not contribute significant calories to the diet. Sucralose is about 600 times sweeter than sucrose but does not add calories. Aspartame is a low-calorie sweetener that is approximately 200 times sweeter than sucrose, and acesulfame potassium is a calorie-free sweetener.

5. Which of the following should a patient with a history of chronic pancreatitis avoid?

• A. Low-fat dairy
• B. Lean meats
• C. High-fiber vegetables
• D. Alcohol

Correct answer: D

Rationale: The correct answer is D: Alcohol. Alcohol consumption can exacerbate chronic pancreatitis due to its detrimental effects on the pancreas. Conversely, options A, B, and C: Low-fat dairy, Lean meats, and High-fiber vegetables, are generally recommended for patients with chronic pancreatitis. These dietary options are easier on the pancreas and less likely to provoke symptoms. Therefore, they are incorrect choices in this context.

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