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. The Acceptable Macronutrient Distribution Ranges state that half of your calories should come from protein.

• A. TRUE
• B. FALSE
• C.
• D.

Correct answer: B

Rationale: The statement is FALSE. The Acceptable Macronutrient Distribution Ranges recommend that 10-35% of daily calories come from protein, not half. The remaining calories should be derived from a combination of carbohydrates and fats to ensure a balanced diet. Choosing option A is incorrect because it misinterprets the recommended percentage for protein intake. Options C and D are left blank as they are not applicable to the question.

3. What physiologic role does calcium play in the body?

• A. Blood clotting, transmission of nerve impulses, muscle contraction and relaxation
• B. Calcium homeostasis, structural integrity of heart muscle
• C. No known metabolic function, caries-preventing properties
• D. ATP energy release; metabolism of fats, carbohydrates, proteins; regulates acid-base balance.

Correct answer: A

Rationale: The correct answer is A: 'Blood clotting, transmission of nerve impulses, muscle contraction and relaxation.' Calcium plays a crucial role in various physiological functions such as blood clotting, transmission of nerve impulses, muscle contraction and relaxation, membrane permeability, and activation of certain enzymes. Choice B is incorrect because while calcium is involved in calcium homeostasis, it is not the only role it plays in the body. Choice C is incorrect as calcium indeed has several known metabolic functions, and it is not solely for preventing caries. Choice D is also incorrect as the functions mentioned are primarily carried out by other nutrients and not specifically by calcium.

4. Nurse DMLM is correct in identifying the correct sequence of events during abdominal assessment if she identifies which of the following?

• A. Inspection, Auscultation, Percussion, Palpation
• B. Inspection, Percussion, Palpation, Auscultation
• C. Inspection, Palpation, Percussion, Auscultation
• D. Inspection, Auscultation, Palpation, Percussion

Correct answer: D

Rationale: The correct sequence for abdominal assessment is Inspection, Auscultation, Percussion, Palpation. Start with Inspection to observe any visible abnormalities, followed by Auscultation to listen for bowel sounds, then Percussion to assess the density of underlying structures, and finally Palpation to feel for any tenderness or masses. Choices A, B, and C have the incorrect sequence of assessment techniques.

5. The RDA for iron is higher in premenopausal women than for men or postmenopausal women because of the blood loss during menstruation.

• A. Both the statement and the reason are correct and related.
• B. Both the statement and the reason are correct but are not related.
• C. The statement is correct, but the reason is not correct.
• D. The statement is not correct, but the reason is correct.

Correct answer: A

Rationale: Both the statement and the reason are correct and related. The Institute of Medicine (IOM) recommends 18 mg of iron per day for women 19 to 50 years old, 8 mg/day for women 51 years old and older, and men 19 years old and older. During menstruation, women lose blood containing iron, leading to a higher iron requirement in premenopausal women compared to men or postmenopausal women. This increased demand aims to replenish the iron lost during this physiological process. Therefore, the statement and reason are directly linked, explaining why the RDA for iron is higher in premenopausal women than in men or postmenopausal women. Choices B, C, and D are incorrect as they do not accurately assess the relationship between the statement and the reason provided in the question.

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