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. During early tooth development, vitamin A deficiency leads to enamel hypoplasia and defective dentin formation. Because of its effect on soft tissues and bone, vitamin A contributes to normal spacing of teeth.

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

Correct answer: A

Rationale: Both statements are true. The effect of vitamin A on the growth of soft tissues and bones naturally extends to the teeth and surrounding structures. Enamel hypoplasia, involving defective enamel matrix and incomplete calcification of enamel and dentin, can be due to vitamin A deficiency. The effect of this vitamin upon surrounding bone directly affects spacing patterns of the teeth within the bone and dentition. Choice A is correct because both statements accurately describe the influence of vitamin A on tooth development. Choices B, C, and D are incorrect as they do not reflect the accuracy of the statements provided.

3. A client with a body mass index of 28 is seeking dietary advice. Which of the following actions should the nurse take?

• A. Encourage the client to continue their current daily caloric intake.
• B. Recommend a total fiber intake of 12g per day.
• C. Advise the client to add 500 calories per day to their diet.
• D. Refer the client to a weight-loss support group.

Correct answer: D

Rationale: Referring the client to a weight-loss support group is the most appropriate action for a client with a body mass index of 28. This action can provide the necessary support, guidance, and motivation to help the client achieve their weight loss goals. Encouraging the client to continue their current daily caloric intake (Choice A) may not address the need for weight loss. Recommending a total fiber intake of 12g per day (Choice B) is important for overall health but may not directly address weight loss. Advising the client to add 500 calories per day to their diet (Choice C) would not be beneficial for weight loss in this scenario.

4. The stages of grieving identified by Elizabeth Kubler-Ross are:

• A. Numbness, anger, resolution and reorganization
• B. Denial, anger, identification, depression and acceptance
• C. Anger, loneliness, depression and resolution
• D. Denial, anger, bargaining, depression and acceptance

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

5. A patient is on a low-sodium diet. Which food item should the patient avoid?

• A. Fresh fruit
• B. Canned soup
• C. Whole grain bread
• D. Grilled chicken

Correct answer: B

Rationale: The correct answer is B: Canned soup. Canned soup is commonly high in sodium content, which is not suitable for a patient on a low-sodium diet. Fresh fruit, whole grain bread, and grilled chicken typically have lower sodium levels and can be included in a low-sodium diet. Therefore, the patient should avoid canned soup to adhere to the requirements of a low-sodium diet.

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