Nursing Elites

1. A nurse is completing an admission assessment on an adolescent client who is vegan. Which breakfast item should the nurse recommend as a protein combination with their diet restriction?

• A. Bagel with cream cheese
• B. Wheat toast with jelly
• C. Oatmeal pancakes with peanut butter
• D. Eggs with tofu bacon

Correct answer: C

Rationale: The correct answer is C: Oatmeal pancakes with peanut butter. For a vegan client, it is important to recommend plant-based protein sources. Oatmeal pancakes with peanut butter offer a good protein combination that aligns with their dietary restriction. Choices A, B, and D are not suitable as they all contain animal-derived products, which are not suitable for a vegan diet.

2. The nurse understands that one of these factors contributes to constipation:

• A. excessive exercise
• B. high fiber diet
• C. no regular time for defecation daily
• D. prolonged use of laxatives

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

3. In a patient with liver cirrhosis, weight gain due to fluid retention can mask the symptoms of what condition?

• A. Liver failure
• B. Gallbladder disease
• C. Heart failure
• D. Protein-Energy Malnutrition (PEM)

Correct answer: D

Rationale: In a patient with liver cirrhosis, weight gain due to fluid retention can mask Protein-Energy Malnutrition (PEM) symptoms. This can lead to an increase in weight, making it challenging to identify weight loss or muscle wasting associated with PEM. Therefore, option D is correct. Options A, B, and C are incorrect because fluid retention and weight gain related to liver cirrhosis do not necessarily hide the symptoms of liver failure, gallbladder disease, or heart failure.

4. Protein-energy malnutrition (PEM) may be responsible for the increased incidence of noma and necrotizing ulcerative gingivitis (NUG) because these conditions are associated with depressed immune responses caused by nutritional deficiencies.

• 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: The corrected question highlights that protein-energy malnutrition weakens the immune system, making individuals more susceptible to conditions like noma and NUG, which are linked to compromised immunity. Choice A is correct because the statement and reason are both accurate and directly related. Protein-energy malnutrition does result in depressed immune responses, which can predispose individuals to noma and NUG. Choice B is incorrect because the statement and reason are indeed related. Choice C is incorrect as both the statement and reason are accurate. Choice D is also incorrect as the statement is correct and directly supports the reason provided.

5. Which suggestion is most appropriate to increase calorie intake for a patient with stomach cancer, aiming to prevent weight loss and wasting?

• A. Replace whole fat milk with skim milk or water
• B. Avoid peanut butter and other nuts
• C. Choose high-fat meat instead of lean meat
• D. Limit alcohol intake to two drinks per day

Correct answer: C

Rationale: The correct answer is C: Choose high-fat meat instead of lean meat. High-fat meats are more calorie-dense than lean meats, which makes them a good choice for increasing calorie intake. This is crucial for patients with stomach cancer who want to avoid weight loss and wasting. Choice A is incorrect because skim milk or water contains fewer calories than whole fat milk. Choice B is also incorrect because peanut butter and nuts are high in calories and therefore should not be avoided when trying to increase calorie intake. Finally, choice D is not a good suggestion to increase calorie intake as alcohol does not provide the necessary nutrients needed for a balanced diet. In fact, excessive alcohol can harm the liver and other organs, and it's not a reliable source of calories.

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