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. Are the following statements both true: 'Most excess energy intake, whether from protein, carbohydrate, alcohol, or fat, is stored in the liver' and 'Fat is a good source of energy, but the preferred fuel is protein'?

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

Correct answer: B

Rationale: Both of the given statements are false. The first statement is inaccurate because the primary location for excess energy storage is not the liver, but rather adipose tissue where it is stored as fat. While the liver does have a role in energy storage and metabolism, it is not the main storage site for excess intake. The second statement is also incorrect. Although fat and protein can be used as sources of energy, the body's preferred source of energy is carbohydrates. They break down more efficiently and are easier for the body to use. The body prefers to conserve protein for other essential functions, such as tissue repair and the production of enzymes. Therefore, protein is not the preferred fuel source.

3. Which animal-derived food contains the most significant level of carbohydrates?

• A. Egg
• B. Beef
• C. Milk
• D. Poultry

Correct answer: C

Rationale: Milk contains the most significant level of carbohydrates among animal-derived foods. Milk and milk products supply significant quantities of carbohydrate in the form of lactose. Eggs, beef, and poultry are not significant sources of carbohydrates compared to milk. In cheese making, lactose is removed as a by-product, reducing the carbohydrate content further.

4. What is the first thing you should do before sharing information with a patient?

• A. Provide background knowledge
• B. Ask for permission
• C. Remove personal protective equipment (PPE)
• D. Remind the patient that you are the authority

Correct answer: B

Rationale: Before sharing information with a patient, it is essential to ask for their permission. This action respects the patient's autonomy and encourages their participation in the learning process. Asking for permission establishes a foundation of trust and partnership between the healthcare provider and the patient. Providing background knowledge (Choice A) is important, but it should come after receiving consent to share information. Removing personal protective equipment (Choice C) is not related to the communication process. Reminding the patient that you are the authority (Choice D) is inappropriate as it can undermine the patient's autonomy and hinder effective communication in a patient-centered care approach.

5. What is the major diet-derived antioxidant found in cell membranes?

• A. B12
• B. beta-carotene
• C. vitamin E
• D. vitamin A

Correct answer: C

Rationale: The correct answer is vitamin E. Vitamin E is the major antioxidant found in cell membranes, where it plays a crucial role in protecting them from oxidative damage. Although B12, beta-carotene, and vitamin A are important nutrients with specific functions in the body, they are not the primary antioxidants found in cell membranes. Vitamin E specifically localizes in cell membranes to neutralize free radicals and prevent lipid peroxidation, making it an essential antioxidant for cellular health.

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