Nursing Elites

1. A nurse is preparing a teaching plan for a client who has neutropenia as a result of radiation therapy for the treatment of lung cancer. Which of the following should the nurse plan to include in the teaching?

• A. Bottled water is an appropriate choice to increase fluid intake.
• B. The salad bar is a healthy choice when dining out.
• C. Soft-boiled eggs are an appropriate source of protein.
• D. Eating at a buffet is a good choice to increase caloric intake.

Correct answer: A

Rationale: In neutropenia, which is a low count of neutrophils, the client is at a high risk of infection. It is crucial to emphasize the importance of proper hydration to maintain overall health. Bottled water is a safe choice as it reduces the risk of exposure to contaminants that could further compromise the client's immune system. The other options, like the salad bar, soft-boiled eggs, and eating at a buffet, may not be suitable for a client with neutropenia due to the risk of bacterial contamination or exposure to pathogens that could lead to infections, which should be avoided.

2. Which of the following is NOT required on a food label or nutrition facts panel?

• A. Nutrition facts panel
• B. Ingredients in descending order by weight
• C. The % RDA of ALL the vitamins and minerals in the product
• D. Essential warnings, such as common allergies

Correct answer: C

Rationale: According to food labeling regulations, every food label or nutrition facts panel must include a nutrition facts panel, list of ingredients in descending order by weight, and essential warnings such as common allergies. However, it is not mandatory to list the % Recommended Daily Allowance (RDA) of ALL the vitamins and minerals in the product. Only certain vitamins and minerals, deemed significant to public health, are required to be listed. Therefore, the notion that the % RDA of ALL vitamins and minerals must be displayed is incorrect. Choices A, B, and D are required elements on a food label, making them incorrect answers.

3. A healthcare provider is evaluating a client who reports paresthesia of the hands and feet. The provider should identify this manifestation as an indication of which of the following dietary deficiencies?

• A. Iron
• B. Riboflavin
• C. Vitamin C
• D. Vitamin B12

Correct answer: D

Rationale: Correct! Vitamin B12 deficiency can lead to neurological symptoms, including paresthesia (tingling or numbness) of the hands and feet, due to its role in nerve health. Iron deficiency is more commonly associated with anemia symptoms like fatigue and pallor. Riboflavin deficiency can cause mouth and skin changes. Vitamin C deficiency is linked to scurvy symptoms like bleeding gums and easy bruising.

4. A nurse is educating a group of older adults in a community center on weight management using the BMI scale. Using the client's height and weight to calculate BMI, which of the following clients has a healthy BMI?

• A. A client with a weight of 128 lb and height of 70 inches
• B. A client with a weight of 150 lb and height of 68 inches
• C. A client with a weight of 200 lb and height of 72 inches
• D. A client with a weight of 133 lb and height of 60 inches

Correct answer: A

Rationale: To determine a healthy BMI, we need to calculate it using the formula: BMI = weight (lbs) / height^2 (inches) x 703. For choice A, BMI = 128 / (70 x 70) x 703 = 18.38, which falls within the healthy BMI range of 18.5-24.9. Therefore, choice A is correct. Choices B, C, and D have BMIs of 22.8, 27.1, and 26.1, respectively, which are outside the healthy range. Thus, choices B, C, and D are incorrect.

5. One of the most common factors that compromise the vitamin D status of older adults, particularly those living in assisted living communities is _____.

• A. decreased intake of fruits and vegetables
• B. lack of physical activity
• C. malabsorption due to atrophic gastritis
• D. lack of exposure to sunlight

Correct answer: D

Rationale: The correct answer is 'D: lack of exposure to sunlight.' Older adults, especially those in assisted living communities, are at risk of vitamin D deficiency due to spending most of their time indoors, which reduces their exposure to sunlight. Sunlight is essential for the body to produce vitamin D. Choices A, B, and C are less likely to be major factors in compromising vitamin D status. While a decreased intake of fruits and vegetables and lack of physical activity can impact overall health, they are not as directly related to vitamin D status. Malabsorption due to atrophic gastritis may affect the absorption of certain nutrients, but vitamin D synthesis primarily depends on sunlight exposure.

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