Nursing Elites

1. A nurse at a provider's office is providing teaching to a client who is taking chemotherapy and losing weight. Which of the following should the nurse recommend to increase calorie and protein intake? (Select one that does not apply.)

• A. Top yogurt with fruits.
• B. Add cream to soups.
• C. Use milk instead of water in recipes.
• D. Increase fluids during meals.

Correct answer: D

Rationale: The correct recommendation to increase calorie and protein intake for a client taking chemotherapy and losing weight is to add cream to soups (choice B), as it provides additional calories and proteins. Using milk instead of water in recipes (choice C) can also increase the calorie and protein content. Topping yogurt with fruits (choice A) can be a healthy choice but may not significantly increase calorie and protein intake. Increasing fluids during meals (choice D) may fill up the stomach, potentially reducing the intake of solid foods, which is not ideal when trying to increase calorie and protein consumption.

2. Which of the following is reflected in an ECG due to hypokalemia?

• A. Tall T waves and Pathologic Q wave
• B. Widening QRS Complex and U wave
• C. None of the above
• D. Both A and B

Correct answer: B

Rationale: Hypokalemia, a condition characterized by low levels of potassium in the blood, is reflected in an ECG by a widening QRS Complex and a U wave. This is because potassium plays a key role in the electrical activity of the heart, and its deficiency can lead to abnormalities in the heart's rhythm as represented by these specific changes on the ECG. Choice A is incorrect as tall T waves and pathologic Q waves are more commonly associated with hyperkalemia or myocardial infarction, respectively, rather than hypokalemia. Choices C and D are also incorrect as they do not accurately reflect the ECG changes caused by hypokalemia.

3. What type of diet would most likely benefit a patient with cystic fibrosis?

• A. Low sodium
• B. Low fat
• C. Clear liquid
• D. High calorie, high protein

Correct answer: D

Rationale: Patients with cystic fibrosis often have malabsorption issues, leading to increased energy needs. A high-calorie, high-protein diet is recommended to help meet these needs, support growth, and maintain overall health. Choices A, B, and C do not address the specific dietary requirements associated with cystic fibrosis, making them less beneficial for these patients.

4. Although a balanced diet is essential for tissue healing and repair, which of the following should the dental hygienist identify as the nutrient of highest priority for a patient with gingivitis or periodontal disease?

• A. Carbohydrates
• B. Vitamin C
• C. Vitamin D
• D. Monosaccharides

Correct answer: B

Rationale: Vitamin C is crucial for collagen production and connective tissue repair, making it a key nutrient for healing gingival tissues in patients with gingivitis or periodontal disease. Carbohydrates are a source of energy and not directly related to tissue repair. Vitamin D is important for bone health but is not the highest priority for gingival tissue healing. Monosaccharides are simple sugars and not as essential for tissue repair as Vitamin C.

5. A nurse is providing teaching to a client who has type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?

• A. Albumin in my urine is an indication of normal kidney function.
• B. I will keep my HbA1c at five percent.
• C. I will have ketones in my urine if my blood glucose is maintained at 190 milligrams per deciliter.
• D. I will keep my blood glucose levels between 200 and 212 milligrams per deciliter.

Correct answer: B

Rationale: The correct answer is B. Maintaining an HbA1c level of 5 percent indicates good long-term blood glucose control and understanding of diabetes management. Choice A is incorrect because the presence of albumin in the urine (albuminuria) is actually an indication of kidney damage in diabetes. Choice C is incorrect as ketones in the urine are a sign of inadequate insulin and can occur when blood glucose levels are high, not at a specific level like 190 mg/dL. Choice D is also incorrect as the client should aim to keep blood glucose levels within a tighter range for better control, typically between 80-130 mg/dL before meals and less than 180 mg/dL after meals.

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