Nursing Elites

1. A nurse is reinforcing teaching about food choices with the mother of an 8-month-old infant. Which of the following statements by the mother indicates a need for further teaching?

• A. I will give my child strained carrots and mashed egg yolks.
• B. I will give my child rice cereal and crackers.
• C. I will give my child pureed liver and strained pears.
• D. I will give my child applesauce and green peas.

Correct answer: B

Rationale: Choice B, 'I will give my child rice cereal and crackers,' indicates a need for further teaching. Infants should not be given crackers at 8 months of age due to the risk of choking. Rice cereal is appropriate for infants, but it should be introduced carefully to avoid digestive issues. Choices A, C, and D are appropriate food choices for an 8-month-old infant, providing a variety of nutrients and textures suitable for their age and developmental stage.

2. Each nonnutritive sweetener can be recommended to patients with phenylketonuria, except one. Which one is the exception?

• A. Cyclamate
• B. Acesulfame-K
• C. Saccharin
• D. Aspartame

Correct answer: D

Rationale: The correct answer is D, Aspartame. Aspartame contains phenylalanine, which is contraindicated for individuals with phenylketonuria (PKU), a genetic disorder that impairs phenylalanine metabolism. Therefore, patients with PKU should avoid aspartame. Choices A, B, and C (Cyclamate, Acesulfame-K, Saccharin) are considered safe for individuals with PKU as they do not contain phenylalanine and can be recommended as alternatives to sugar for these patients.

3. Where does carbohydrate digestion begin?

• A. Mouth
• B. Esophagus
• C. Stomach
• D. Small intestine

Correct answer: A

Rationale: Carbohydrate digestion begins in the mouth. The enzyme amylase, found in saliva, starts the process by breaking down starches into sugars. The esophagus is a passageway for food to reach the stomach and does not participate in digestion. The stomach mainly digests proteins and is not the primary site for carbohydrate breakdown. While the small intestine does play a crucial role in digesting carbohydrates, it is not where the process initiates. Therefore, the correct answer is the mouth.

4. A nurse is providing anticipatory guidance to a client who has Phenylketonuria (PKU) and is planning a pregnancy. Which of the following information should the nurse include in the discussion?

• A. Diet sodas should not be consumed more than two or three times a week.
• B. Serum bilirubin should be monitored once or twice a month during pregnancy.
• C. Breastfeeding will not prevent your baby from developing PKU.
• D. A low-protein diet should be followed for three months before conception.

Correct answer: D

Rationale: A low-protein diet should be followed for three months before conception in individuals with PKU who are planning a pregnancy. This diet helps manage PKU by reducing phenylalanine levels, which is crucial for maternal and fetal health. Choices A, B, and C are incorrect. Choice A is not directly related to managing PKU, choice B focuses on a different aspect of care during pregnancy, and choice C is inaccurate as breastfeeding will not prevent a baby from developing PKU.

5. A nurse is caring for a client who has a body mass index (BMI) of 30. Four weeks after nutritional counseling, which of the following evaluation findings indicates the plan of care was followed?

• A. BMI of 25
• B. Weight gain of 1.8 kg
• C. BMI of 33
• D. Weight loss of 2.7 kg

Correct answer: D

Rationale: A weight loss of 2.7 kg in four weeks indicates effective adherence to a nutritional plan aimed at reducing body mass index (BMI), moving towards a healthier weight. Choices A, B, and C are incorrect because a decrease in weight, as shown in choice D, is the desired outcome when managing a client with a BMI of 30 to reach a healthier range.

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