Nursing Elites

1. A healthcare provider is teaching a client who has constipation about a high-fiber diet. Which of the following foods should be included as sources of fiber? (Select one that does not apply.)

• A. Whole wheat bread
• B. Kidney beans
• C. Refined cereals
• D. Blackberries

Correct answer: C

Rationale: Refined cereals are not a good source of fiber as they have been processed and stripped off most of their fiber content. Whole wheat bread, kidney beans, and blackberries are excellent sources of fiber. Whole wheat bread is made from whole grains, which are high in fiber. Kidney beans are rich in fiber and can help alleviate constipation. Blackberries are a good source of fiber and can aid in promoting bowel regularity.

2. Medication for treating high blood cholesterol levels should not be used for most people unless:

• A. The patient has at least three major risk factors for coronary heart disease
• B. The patient has been experiencing symptoms of coronary heart disease for at least three months
• C. The patient's medical insurance covers prescription drugs
• D. Treatment with Therapeutic Lifestyle Changes (TLC) alone is unsuccessful after three months

Correct answer: D

Rationale: The correct answer is choice D because medication for high cholesterol is typically not considered unless Therapeutic Lifestyle Changes (TLC), which include diet and exercise, have not proven effective after a three-month period. This approach ensures that lifestyle modifications are given a fair chance to lower cholesterol levels before resorting to medication. Choice A is incorrect because the number of risk factors for coronary heart disease does not dictate when to begin medication; it is about the effectiveness of lifestyle changes. Choice B is incorrect as the duration of coronary heart disease symptoms does not determine when to start medication; the focus is on the response to TLC. Choice C is incorrect because the coverage of prescription drugs by the patient's insurance does not influence the medical decision to use medication for high cholesterol; it is based on medical necessity and effectiveness of prior interventions.

3. An elderly man is hospitalized with a diagnosis of malnutrition three months following his wife's death. What risk factor for malnutrition does this scenario illustrate?

• A. A history of chronic illness
• B. Depression or social isolation
• C. Age
• D. Impaired mobility

Correct answer: B

Rationale: This scenario illustrates depression or social isolation as a risk factor for malnutrition. After the death of his wife, the elderly man may have experienced depression or social isolation, which can lead to decreased food intake and poor nutritional status. Although age, chronic illness, and impaired mobility can also contribute to malnutrition, they are not the primary factors described in this scenario. The history of chronic illness (Choice A) and impaired mobility (Choice D) were not mentioned in the scenario, and while age (Choice C) is a factor, it's not the main factor depicted in this case.

4. Which statement about essential nutrients should the nurse include?

• A. Fat-containing foods can help to decrease triglyceride levels.
• B. Animal sources of protein contain 20 essential amino acids.
• C. Carbohydrates are the primary source of fuel for muscles and the brain.
• D. High-fiber foods are a good source of energy.

Correct answer: C

Rationale: The correct answer is C because carbohydrates are indeed the primary source of fuel for muscles and the brain. Choice A is incorrect because while certain fats are essential, they do not help decrease triglyceride levels. Choice B is incorrect because animal sources of protein do not contain all 20 essential amino acids. Choice D is incorrect because although high-fiber foods are important for digestion and overall health, they are not a direct source of energy.

5. What information should a working mother who wants to continue breastfeeding her infant by occasionally pumping milk ahead of time be given to help her successfully maintain breastfeeding?

• A. Breast milk can be refrigerated for up to 4 days
• B. Breast milk stored in a deep freezer can be kept for up to 12 months
• C. Heating breast milk in the microwave can degrade its nutritional quality
• D. Breast milk can be expressed either by hand or with an electric pump

Correct answer: D

Rationale: The correct answer is D. This information is crucial as it informs the mother of her options for expressing milk, which is the first step in being able to store and later feed it to her child while she's away at work. Choice A has been corrected to state that breast milk can be refrigerated for up to 4 days, providing a more accurate storage timeframe. Choice B has been revised to indicate that breast milk stored in a deep freezer can be kept for up to 12 months, aligning with the recommended storage duration. Choice C now highlights that heating breast milk in the microwave can degrade its nutritional quality, emphasizing the importance of using proper methods for warming breast milk and avoiding potential harm to the baby's health and well-being.

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