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. After ileostomy, which of the following condition is NOT expected?

• A. Increased weight
• B. Irritation of skin around the stoma
• C. Liquid stool
• D. Establishment of regular bowel movement

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

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. What is the digestive action of lipase?

• A. It breaks down carbohydrates
• B. It breaks down proteins
• C. It breaks down lipids
• D. It aids in fat digestion

Correct answer: C

Rationale: Lipase is an enzyme that specifically breaks down lipids (fats) during the process of digestion, converting them into fatty acids and glycerol. This is why option C is the correct answer. Although option D is partially correct, it's less specific than option C. Lipase does not break down carbohydrates or proteins, so options A and B are incorrect.

5. A client has a small-bore jejunostomy and is receiving a continuous tube feeding with a high-viscosity formula. Which of the following actions should the nurse take to prevent the tubing from clogging?

• A. Replace the bag and tubing every 24 hours
• B. Flush the tubing with 10 mL water every 6 hours
• C. Administer the feeding by gravity drip
• D. Heat the formula prior to infusion

Correct answer: B

Rationale: To prevent clogging when using high-viscosity formulas in a small-bore jejunostomy, the nurse should flush the tubing with 10 mL of water every 6 hours. This action helps maintain tube patency and prevent blockages. Replacing the bag and tubing every 24 hours (Choice A) is unnecessary and does not specifically address preventing clogging. Administering the feeding by gravity drip (Choice C) or heating the formula prior to infusion (Choice D) are not effective interventions for preventing tubing clogging.

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