Nursing Elites

1. 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.

2. A nurse is caring for a client who has a body mass index (BMI) of 30. Four weeks after nutritional counseling, which of the following evaluation findings indicates the plan of care was followed?

• A. BMI of 25
• B. Weight gain of 1.8 kg
• C. BMI of 33
• D. Weight loss of 2.7 kg

Correct answer: D

Rationale: A weight loss of 2.7 kg in four weeks indicates effective adherence to a nutritional plan aimed at reducing body mass index (BMI), moving towards a healthier weight. Choices A, B, and C are incorrect because a decrease in weight, as shown in choice D, is the desired outcome when managing a client with a BMI of 30 to reach a healthier range.

3. During the later stages of chronic kidney disease, what is the recommended protein intake in grams per kilogram of body weight per day?

• A. 0.6 to 0.75
• B. 1.2 to 1.55
• C. 1.0 to 1.2
• D. 0.8 to 1.0

Correct answer: A

Rationale: In the later stages of chronic kidney disease, the recommended protein intake is typically restricted to 0.6 to 0.75 grams per kilogram of body weight per day. This lower protein intake helps reduce the workload on the kidneys, as excessive protein can be challenging for the kidneys to process. Choice B (1.2 to 1.55) is incorrect as it suggests a higher protein intake, which is not recommended for individuals with advanced kidney disease. Choices C (1.0 to 1.2) and D (0.8 to 1.0) also advocate for protein intakes higher than what is typically advised for individuals in later stages of chronic kidney disease.

4. Which gluten-free food choice would be most appropriate for a patient with celiac disease?

• A. Scalloped potatoes
• B. Oatmeal
• C. Eggs
• D. Tortillas

Correct answer: C

Rationale: Eggs are a safe food choice for individuals with celiac disease as they are naturally gluten-free. Scalloped potatoes often contain flour in the sauce, which might contain gluten. Oatmeal can be a subject of debate due to possible cross-contamination during processing, so it might not be safe unless labeled gluten-free. Tortillas are typically made from wheat flour containing gluten, but gluten-free versions are available. However, eggs are universally gluten-free, making them the best choice for individuals with celiac disease.

5. Each statement is true of calcium within saliva, except one. Which is the exception?

• A. Saliva is supersaturated with calcium.
• B. Saliva is a source of calcium to mineralize an immature or demineralized enamel surface.
• C. Calcium and phosphate in saliva provide a buffering action.
• D. Calcium within saliva increases dental caries.

Correct answer: D

Rationale: The correct answer is D. Calcium within saliva does not increase dental caries; in fact, the buffering action provided by calcium and phosphate in saliva inhibits caries formation by preventing the dissolution of enamel by plaque biofilm. Choice A is correct as saliva is indeed supersaturated with calcium. Choice B is correct as saliva serves as a source of calcium to mineralize an immature or demineralized enamel surface. Choice C is correct as calcium and phosphate in saliva do provide a buffering action to protect teeth from acids.

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