Nursing Elites

1. A client with diabetes is being taught by a nurse about the dietary source that should provide the greatest percentage of calories. Which of the following statements indicates the client understands the teaching?

• A. "Most of my calories each day should be from fats."?
• B. "I should eat more calories from complex carbohydrates than anything else."?
• C. "Simple sugars are needed more than other calorie sources."?
• D. "Protein should be my main source of calories."?

Correct answer: B

Rationale: The correct answer is '"I should eat more calories from complex carbohydrates than anything else."?' Clients with diabetes should focus on complex carbohydrates as their primary calorie source because they have a lower impact on blood sugar levels compared to simple sugars or fats. Choice A is incorrect because a high intake of fats can lead to various health issues. Choice C is incorrect because simple sugars can cause rapid spikes in blood sugar levels. Choice D is incorrect as while protein is important, it should not be the main source of calories for someone with diabetes.

2. A nurse in a long-term care facility is developing strategies to promote increased food intake for an older adult client. Which of the following interventions should the nurse implement?

• A. Offer sugar substitutes to increase the client’s appetite.
• B. Provide opportunities to eat three large meals per day.
• C. Provide entertainment while the client is eating.
• D. Offer finger foods at mealtime.

Correct answer: D

Rationale: The correct intervention for promoting increased food intake for an older adult client is to offer finger foods at mealtime. Finger foods are easier for older adults to manage, making eating less cumbersome and more enjoyable, which can help increase overall food intake. Providing sugar substitutes (Choice A) may not necessarily increase appetite and could have negative health effects. Eating three large meals per day (Choice B) may be overwhelming and not suitable for older adults who may prefer smaller, more frequent meals. While providing entertainment (Choice C) during meals can be beneficial in some cases, it may not directly contribute to increased food intake as effectively as offering finger foods.

3. A community health nurse is conducting a class on what to expect during pregnancy. What instruction should the nurse include on weight gain?

• A. Failure to obtain the required weight gain during pregnancy will increase the risk of preterm birth.
• B. An obese client should not gain as much weight as a client with a normal body mass index.
• C. A client with a normal body mass index should plan on gaining 50 pounds.
• D. Clients do not need to eat for two when they are pregnant.

Correct answer: A

Rationale: Adequate weight gain during pregnancy is essential as failure to obtain the required weight gain can increase the risk of preterm birth. Choice B is incorrect because it is important for obese clients to gain an appropriate amount of weight during pregnancy, not the same as those with a normal body mass index. Choice C is incorrect as gaining 50 pounds for a client with a normal body mass index is excessive. Choice D is incorrect as the common saying 'eating for two' during pregnancy is a misconception; pregnant individuals do not need to double their caloric intake.

4. When surgery is on-going, who coordinates the activities outside, including the family?

• A. Orderly/clerk C. Circulating Nurse
• B. Nurse Supervisor D. Anesthesiologist
• C.
• D.

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

5. For an incontinent elderly client who frequently wets his bed and develops redness and skin excoriation at the perianal area, what is the best nursing goal?

• A. Ensure that the bed linen is always dry
• B. Frequently check the bed for wetness and keep it dry
• C. Place a rubber sheet under the client's buttocks
• D. Keep the patient clean and dry

Correct answer: A

Rationale: The best nursing goal for an incontinent elderly client with skin excoriation is to ensure that the bed linen is always dry. This helps in preventing further skin breakdown and promoting skin integrity. Choice B, to frequently check the bed for wetness and keep it dry, may not address the issue of prevention if the linen is not consistently dry. Choice C, placing a rubber sheet under the client's buttocks, focuses more on protecting the mattress rather than addressing the client's skin condition directly. Choice D, keeping the patient clean and dry, is important but does not specifically address the preventive aspect of maintaining dry bed linen.

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