Nursing Elites

1. A nurse is developing a program about strategies to prevent foodborne illnesses for a community group. The nurse should plan to include which of the following recommendations? (Select one that does not apply).

• A. Keep cold food temperatures below 4.4�C (40�F).
• B. Reheat leftovers before eating.
• C. Wash raw vegetables thoroughly in clean water.
• D. Keep cooked foods at 48.9�C (120�F).

Correct answer: D

Rationale: The correct answer is to keep cooked foods at 48.9�C (120�F). This temperature is too low to keep cooked foods safe from bacterial growth. The ideal temperature to keep cooked foods safe is above 60�C (140�F). Choices A, B, and C are all important strategies to prevent foodborne illnesses. Keeping cold food temperatures below 4.4�C (40�F) helps prevent bacterial growth, reheating leftovers before eating kills any bacteria that may have grown during storage, and washing raw vegetables thoroughly in clean water helps remove dirt and bacteria.

2. Each of the following accurately describes aspects of the dietary reference intakes (DRIs) published by the Food and Nutrition Board of the Institute of Medicine (IOM) except one. Which one is the exception?

• A. The DRIs replace the older recommended daily allowances
• B. Current DRIs attempt to estimate required nutrients to improve long-term health
• C. DRIs specifically address individuals whose requirements are affected by a disease state
• D. The DRIs attempt to establish maximum safe levels of tolerance for nutrients

Correct answer: C

Rationale: The correct answer is C. DRIs are intended for the general population and do not specifically address disease states, which are managed with different clinical guidelines. Choice A is correct as DRIs have replaced the older recommended daily allowances. Choice B is correct as current DRIs aim to estimate the required nutrients for long-term health. Choice D is correct as DRIs also attempt to establish maximum safe levels of tolerance for nutrients.

3. 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.

4. Studies suggest that leukoplakia is resolved by excess vitamin A (a fat-soluble vitamin), retinoids, and beta-carotene. Leukoplakia is a white plaque that forms on oral mucous membranes.

• A. Both statements are true.
• B. Both statements are false.
• C. The first statement is true; the second is false.
• D. The first statement is false; the second is true.

Correct answer: B

Rationale: Both statements are false. Studies suggest that leukoplakia, a white plaque that forms on oral mucous membranes, can be resolved by vitamin A, retinoids, and beta-carotene. Despite the potential to resolve leukoplakia, relapse is common. Also pertinent, evidence does not indicate that any of these nutrients prevent malignant transformation. The extract provided clarifies that leukoplakia is a white plaque, not an erythematous lesion, and that vitamin A, retinoids, and beta-carotene can help resolve it.

5. A client has acute dysphagia. Which of the following nursing interventions should be included in the plan of care?

• A. Providing a straw for consumption of liquids
• B. Encouraging larger bites
• C. Placing the client in semi-Fowler's position during meals
• D. Instructing the client to tilt head forward when swallowing

Correct answer: C

Rationale: Placing the client in semi-Fowler's position during meals is the correct intervention for a client with acute dysphagia. This position helps prevent aspiration by facilitating swallowing. Providing a straw for consumption of liquids (Choice A) can increase the risk of aspiration and is not recommended for clients with dysphagia. Encouraging larger bites (Choice B) can also increase the risk of choking and aspiration. Instructing the client to tilt the head forward when swallowing (Choice D) is not the recommended technique for managing dysphagia as it does not address the underlying issue effectively.

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