Nursing Elites

1. 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: B

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.

2. What is a likely effect on a patient whose lab results reveal hypoalbuminemia?

• A. Infection
• B. Rickets
• C. Hypertension
• D. Edema

Correct answer: D

Rationale: Hypoalbuminemia, which refers to low albumin levels in the blood, is often associated with edema. Albumin helps maintain oncotic pressure, which keeps fluid within blood vessels. When albumin levels are low, this pressure decreases, leading to fluid leakage from the blood vessels into the surrounding tissues, resulting in edema. The other choices are less likely effects of hypoalbuminemia. Hypoalbuminemia doesn't directly cause infections (Choice A), rickets (Choice B) caused by vitamin D deficiency, or hypertension (Choice C) associated with factors like high sodium intake, obesity, and genetic predisposition.

3. What is the best dietary advice for a patient with iron-deficiency anemia?

• A. Increase dairy consumption
• B. Increase vitamin C intake
• C. Reduce red meat consumption
• D. Increase fiber intake

Correct answer: B

Rationale: The best dietary advice for a patient with iron-deficiency anemia is to increase vitamin C intake. Vitamin C enhances the absorption of non-heme iron, which can help improve iron-deficiency anemia. Choices A, C, and D are not the best options for this condition. Increasing dairy consumption (Choice A) may not directly address the iron deficiency. Reducing red meat consumption (Choice C) may limit heme iron intake, which is easily absorbed by the body. Increasing fiber intake (Choice D) is generally beneficial but is not specifically recommended as the top advice for iron-deficiency anemia.

4. If it is determined that a child is being physically abused by a parent, what would be the most important goal for the nurse to establish with the family?

• A. The child and any siblings will reside in a secure environment
• B. The family will feel at ease in their relationship with the counselor
• C. The family will gain insight into their abusive behavior patterns
• D. The mother will learn to apply verbal discipline with her children

Correct answer: A

Rationale: The primary objective when dealing with cases of child abuse is to ensure the safety of the child and any siblings. This means creating a secure environment free from harm, which is why choice 'A' is the correct answer. While choices 'B', 'C', and 'D' might be subsequent steps in a comprehensive plan to deal with the situation, they are not the immediate priority. Understanding abusive behavioral patterns or improving the relationship with the counselor will not directly lead to the child's safety. Likewise, teaching the mother to apply verbal discipline doesn't guarantee the child's safety if the abusive behavior continues. Therefore, these options are not the most important initial goal.

5. Each nonnutritive sweetener can be recommended to patients with phenylketonuria, except one. Which one is the exception?

• A. Cyclamate
• B. Acesulfame-K
• C. Saccharin
• D. Aspartame

Correct answer: D

Rationale: The correct answer is D, Aspartame. Aspartame contains phenylalanine, which is contraindicated for individuals with phenylketonuria (PKU), a genetic disorder that impairs phenylalanine metabolism. Therefore, patients with PKU should avoid aspartame. Choices A, B, and C (Cyclamate, Acesulfame-K, Saccharin) are considered safe for individuals with PKU as they do not contain phenylalanine and can be recommended as alternatives to sugar for these patients.

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