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. A group of clients is being instructed by a nurse regarding nutrition. The teaching should state that which of the following groups of foods contains the highest level of carbohydrates?

• A. Milk, eggs, and cheese
• B. Butter, oils, and avocados
• C. Rice, potatoes, and oranges
• D. Chicken, green beans, and apples

Correct answer: C

Rationale: The correct answer is C: Rice, potatoes, and oranges. These foods are rich in carbohydrates. Choice A (Milk, eggs, and cheese) contains minimal carbohydrates as they are primarily sources of protein and fat. Choice B (Butter, oils, and avocados) contains very little to no carbohydrates as they are high in fats. Choice D (Chicken, green beans, and apples) also contains minimal carbohydrates, with protein and fiber being more prominent in these foods.

3. For an incontinent elderly client who frequently wets his bed and develops redness and skin excoriation at the perianal area, what is the best nursing goal?

• A. Ensure that the bed linen is always dry
• B. Frequently check the bed for wetness and keep it dry
• C. Place a rubber sheet under the client's buttocks
• D. Keep the patient clean and dry

Correct answer: A

Rationale: The best nursing goal for an incontinent elderly client with skin excoriation is to ensure that the bed linen is always dry. This helps in preventing further skin breakdown and promoting skin integrity. Choice B, to frequently check the bed for wetness and keep it dry, may not address the issue of prevention if the linen is not consistently dry. Choice C, placing a rubber sheet under the client's buttocks, focuses more on protecting the mattress rather than addressing the client's skin condition directly. Choice D, keeping the patient clean and dry, is important but does not specifically address the preventive aspect of maintaining dry bed linen.

4. Each of the following is a function of the liver except one. Which one is the exception?

• A. Regulatory control of nutrients in the bloodstream
• B. Conversion of monosaccharides to triglycerides
• C. Breakdown of polysaccharide glycogen into glucose
• D. Oxidation of digestive end products to provide energy

Correct answer: B

Rationale: The correct answer is B. The liver does not convert monosaccharides to triglycerides; instead, it converts monosaccharides to glucose or glycogen. Choice A is correct because the liver plays a role in regulating the levels of various nutrients in the bloodstream. Choice C is correct as the liver breaks down stored glycogen into glucose to maintain blood sugar levels. Choice D is correct as the liver oxidizes digestive end products to provide energy. Therefore, only choice B is incorrect as the liver does not convert monosaccharides to triglycerides.

5. Which of the following are the primary bacteria involved in the initiation of dental caries?

• A. Streptococcus mutans and Lactobacillus species
• B. Salmonella and Listeria species
• C. Streptococcus, Lactobacillus, and Salmonella species
• D. Listeria, Botulinum species, and Escherichia coli

Correct answer: A

Rationale: The correct answer is A: Streptococcus mutans and Lactobacillus species. These bacteria are primarily responsible for initiating dental caries by fermenting carbohydrates and producing acids that demineralize enamel. Choice B, Salmonella and Listeria species, are not the primary bacteria involved in dental caries. Choice C includes Salmonella which is not a primary culprit in dental caries. Choice D lists Listeria, Botulinum species, and Escherichia coli, none of which are the primary bacteria associated with initiating dental caries.

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