Nursing Elites

1. A nurse is completing an admission assessment on an adolescent client who is a vegetarian. He eats milk products but does not like beans. Which of the following items should the nurse suggest the client order for lunch to provide the nutrients most likely to be lacking in his diet?

• A. Peanut butter and jelly sandwich
• B. Baked potato topped with sour cream
• C. Bagel with cream cheese
• D. Fruit salad

Correct answer: Fruit salad

Rationale: The correct answer is 'Fruit salad.' Since the adolescent client is a vegetarian who eats milk products but does not like beans, suggesting a fruit salad for lunch would provide essential nutrients like vitamins, minerals, and fiber that are commonly found in fruits. Fruit salad can help supplement the nutrients that may be lacking in his diet. Choices A, B, and C do not offer the same variety and quantity of nutrients as a fruit salad, making them less optimal choices for meeting the client's dietary needs.

2. A nurse is caring for an 8-month-old infant who screams when the parent leaves the room. The parent begins to cry and says, 'I don't understand why my child is so upset. I've never seen my child act this way around others before.' Which of the following statements should the nurse make?

• A. This is a normal, expected reaction for a child of this age.
• B. This is a response to an overstimulating environment.
• C. This is a common reaction to an overexposure to caregivers.
• D. This is a typical reaction for a child who is sick.

Correct answer: This is a normal, expected reaction for a child of this age.

Rationale: The correct answer is 'This is a normal, expected reaction for a child of this age.' Separation anxiety typically peaks around 8-10 months of age, leading to distress when separated from caregivers. Choice B is incorrect because the infant's behavior is more likely due to separation anxiety rather than overstimulation. Choice C is incorrect as the infant's behavior is not related to overexposure to caregivers but rather a natural developmental stage. Choice D is incorrect as the infant's behavior is not indicative of illness but rather a normal emotional response.

3. A nurse is caring for an antepartum client who has iron-deficiency anemia. When teaching the client about nutrition, the nurse should emphasize the need for an increased intake of which of the following foods?

• A. Milk and cheese
• B. Red meat and organ meat
• C. Fresh fruits
• D. Whole grain breads

Correct answer: Red meat and organ meat

Rationale: The correct answer is red meat and organ meat. These foods are rich sources of heme iron, which is more easily absorbed by the body compared to non-heme iron found in plant-based foods. Red meat and organ meat can significantly help in increasing the iron levels in individuals with iron-deficiency anemia, especially in antepartum clients. Fresh fruits, while nutritious, do not provide high amounts of iron. Milk and cheese are not the best sources of iron for individuals with iron-deficiency anemia. Whole grain breads also do not contain as much bioavailable iron as red meat and organ meat.

4. A client with gastroesophageal reflux disease is being taught by a nurse about managing the illness. Which of the following recommendations should the nurse include in the teaching?

• A. Limit fluid intake not related to meals.
• B. Chew on mint leaves to relieve indigestion.
• C. Avoid eating within 3 hours of bedtime.
• D. Season foods with black pepper.

Correct answer: Avoid eating within 3 hours of bedtime.

Rationale: The correct recommendation for managing gastroesophageal reflux disease is to avoid eating within 3 hours of bedtime. This helps prevent acid reflux by allowing food to digest before lying down. Choices A, B, and D are incorrect. Limiting fluid intake not related to meals is not a standard recommendation for managing GERD. Chewing on mint leaves may worsen symptoms as mint can relax the lower esophageal sphincter, allowing stomach acid to flow back up. Seasoning foods with black pepper does not specifically help manage GERD.

5. A client is on a 2,000-calorie American Diabetes Association (ADA) diet and substitutes whole milk with skim milk. Which of the following items can the client add to the oatmeal on his breakfast tray?

• A. One 1/8 teaspoon of salt
• B. One ounce of raisins
• C. One tablespoon of low-fat margarine
• D. One teaspoon of brown sugar

Correct answer: One ounce of raisins

Rationale: The correct answer is one ounce of raisins. Raisins are a healthy option to add to oatmeal as they provide natural sweetness without added sugars. They are a good source of fiber and essential nutrients. Option A, one 1/8 teaspoon of salt, is not necessary for flavoring oatmeal. Option C, one tablespoon of low-fat margarine, may add unnecessary fat to the meal. Option D, one teaspoon of brown sugar, adds extra sugar, which should be limited in a diabetes-friendly diet.

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