Nursing Elites

1. A client with frequent kidney stones is receiving dietary teaching from a nurse. Which of the following instructions should the nurse include?

• A. Limit your intake of dairy products.
• B. Increase your consumption of protein-rich foods.
• C. Avoid eating tree nuts, such as almonds.
• D. Take a vitamin C supplement twice daily.

Correct answer: A

Rationale: The correct answer is to instruct the client to limit their intake of dairy products. Dairy products are high in calcium and can contribute to kidney stone formation in susceptible individuals. Increasing protein intake may lead to higher excretion of calcium, which can exacerbate kidney stone formation. While tree nuts are high in oxalates, which can contribute to kidney stone formation, it is not the primary concern in this case. Vitamin C supplements can increase oxalate levels in the urine, potentially increasing the risk of kidney stone formation, so it should not be recommended.

2. Which set of guidelines is intended to assess nutrient adequacy or plan intakes of population groups, not individuals?

• A. Old Recommended Dietary Allowances (RDA)
• B. Estimated Average Requirement (EAR)
• C. New Recommended Dietary Allowances (RDA)
• D. Tolerable Upper Intake Level (UL)

Correct answer: B

Rationale: The Estimated Average Requirement (EAR) is specifically designed to assess nutrient adequacy or plan intakes for population groups, not for individuals. The Old and New Recommended Dietary Allowances (RDA) are meant for individuals, not groups, as they provide guidelines for specific nutrient intake levels for healthy individuals. The Tolerable Upper Intake Level (UL) is used to set the highest level of nutrient intake that is likely to pose no risk of adverse health effects for most individuals in a group, which is different from assessing nutrient adequacy for groups.

3. Which type of diabetes is often associated with a BMI greater than 25 and an increased percentage of body fat, particularly in the abdominal region, contributing to insulin resistance?

• A. Type 1 Diabetes
• B. Type 2 Diabetes
• C. Gestational Diabetes
• D. Prediabetes

Correct answer: B

Rationale: The correct answer is B. Type 2 Diabetes is often associated with a BMI greater than 25 and an increased percentage of body fat, particularly in the abdominal region, contributing to insulin resistance. Type 1 Diabetes is an autoimmune condition not primarily linked to BMI or body fat percentage. Gestational Diabetes occurs during pregnancy and is not directly related to BMI. Prediabetes is a condition where blood sugar levels are higher than normal but not high enough to be diagnosed as Type 2 Diabetes; although it can be associated with higher BMI, it is not as definitive as in Type 2 Diabetes.

4. What chronic disease has been associated with increased risks of dental problems?

• A. diabetes mellitus
• B. chronic obstructive pulmonary disease
• C. Addison's disease
• D. asthma

Correct answer: A

Rationale: Diabetes mellitus is associated with an increased risk of dental problems, including gum disease and tooth loss, due to high blood sugar levels. While chronic obstructive pulmonary disease (COPD), Addison's disease, and asthma may have oral health implications, diabetes mellitus is specifically known for its strong association with dental issues.

5. What is the procedure called when direct observations are used to generate an estimate of a client's current food intake?

• A. Food diary
• B. 24-hour recall
• C. Kilocalorie count
• D. Nutrient surveillance record

Correct answer: C

Rationale: A kilocalorie count is the correct answer as it involves directly observing a client's food intake, which is often used in hospitals to accurately assess nutritional intake and ensure it meets dietary requirements. A food diary (Choice A) is typically self-reported by the client and not directly observed. A 24-hour recall (Choice B) is also usually self-reported and relies on a client's memory of the past 24 hours, which can be unreliable. A nutrient surveillance record (Choice D) is a broader term for tracking nutrient intake in a population and is not specific to the direct observation of an individual's food intake.

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