Nursing Elites

1. A client with cirrhosis and ascites is being cared for by a nurse. Which of the following interventions should the nurse include in the plan of care?

• A. Decrease the client's fluid intake.
• B. Increase the client's saturated fat intake.
• C. Increase the client's sodium intake.
• D. Decrease the client's carbohydrate intake.

Correct answer: D

Rationale: In a client with cirrhosis and ascites, decreasing carbohydrate intake is essential as it helps reduce the production of ascitic fluid. Excess carbohydrates can lead to fluid retention. Choices A, B, and C are incorrect. Decreasing fluid intake can worsen dehydration, increasing saturated fat intake is not recommended due to its impact on liver health, and increasing sodium intake can worsen fluid retention and exacerbate ascites in these clients.

2. Inadequate intake of vitamin A occurs in lower socioeconomic groups due to a lack of resources to purchase and consume vegetables and fruits.

• 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. Inadequate intake of vitamin A in lower socioeconomic groups is due to a lack of resources to purchase and consume vegetables and fruits. This is supported by the fact that the average intake in the United States meets the Recommended Dietary Allowance (RDA) for vitamin A intake, except in lower socioeconomic groups. These individuals often lack the financial means to buy, prepare, and eat a variety of fruits and vegetables, leading to deficiencies. It's important to note that because vitamin A can be stored in the liver, most adults have sufficient quantities to maintain health. Choices B, C, and D are incorrect because the statement and reason are both accurate and logically connected, as the lack of resources directly impacts the ability to obtain necessary sources of vitamin A.

3. What is the best snack choice for a preschool-age child?

• A. Fruit snacks
• B. Mini wheat bagel with peanut butter
• C. White toast with jelly
• D. Sports drink

Correct answer: B

Rationale: The best snack choice for a preschool-age child is a mini wheat bagel with peanut butter as it provides a good balance of carbohydrates, protein, and healthy fats. Fruit snacks, although they contain some fruit flavor, are often high in added sugars and lack essential nutrients. White toast with jelly may provide quick energy but lacks protein and healthy fats, which are important for a balanced snack choice. Sports drinks are typically high in sugar and unnecessary for a preschool-age child's snack, as they are designed for rehydration during intense physical activity, not as a regular snack option.

4. Tony is to be discharged in the afternoon of the same day after tonsillectomy and adenoidectomy. You, as the RN, will make sure that the family knows to:

• A. offer pureed foods
• B. offer soft foods for a week to minimize discomfort while swallowing
• C. supplement his diet with Vitamin C-rich foods to enhance healing
• D. offer clear liquids for 3 days to prevent irritation

Correct answer: B

Rationale: After tonsillectomy and adenoidectomy, it is crucial to provide soft foods for a week to minimize discomfort while swallowing. This helps prevent irritation to the surgical site and allows for easier healing. Offering pureed foods (Choice A) may not be necessary as soft foods are usually sufficient. While Vitamin C is beneficial for healing, it is not necessary to supplement it immediately after surgery with Vitamin C-rich juices (Choice C). Clear liquids are typically recommended before surgery and not after, as the focus shifts to soft foods to aid in recovery, making Choice D incorrect.

5. A nurse is providing nutritional education to a client who is obese. The nurse should include in the information that which of the following gastrointestinal disorders is commonly associated with obesity?

• A. Peptic ulcer disease
• B. Gastroesophageal reflux disease
• C. Celiac disease
• D. Crohn’s disease

Correct answer: B

Rationale: Gastroesophageal reflux disease (GERD) is commonly associated with obesity due to increased abdominal pressure and other factors. Peptic ulcer disease (Choice A) is not commonly associated with obesity. Celiac disease (Choice C) is an autoimmune disorder triggered by gluten consumption and is not directly linked to obesity. Crohn’s disease (Choice D) is a type of inflammatory bowel disease and is not specifically associated with obesity.

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