Nursing Elites

1. A nurse is teaching a client who needs to increase their daily fluid intake. Which of the following foods has the highest percentage of water by weight?

• A. Yogurt
• B. Milk
• C. Lettuce
• D. Honey

Correct answer: C

Rationale: The correct answer is Lettuce. Lettuce has the highest percentage of water by weight among the options provided, making it an excellent choice to increase fluid intake. Yogurt and milk have some water content but are not as high in water percentage as lettuce. Honey, on the other hand, contains very little water and is not a good choice for increasing fluid intake.

2. James wants to know the recommended intake for iron for his gender and age. Which of the following would provide the best answer for James?

• A. EAR
• B. UL
• C. RDA
• D. DV

Correct answer: C

Rationale: The Recommended Dietary Allowance (RDA) is the correct answer for James because it provides the daily intake level that meets the nutrient needs of most healthy individuals in a specific age and gender group. Choice A, EAR (Estimated Average Requirement), represents the average daily nutrient intake level estimated to meet the requirement of half the healthy individuals in a particular life stage and gender group. Choice B, UL (Tolerable Upper Intake Level), is the maximum daily intake unlikely to cause adverse health effects. Choice D, DV (Daily Value), is a general guide used for food labeling that represents how much a nutrient in a serving of food contributes to a daily diet based on a 2000-calorie daily intake.

3. Which of the following actions are individuals with loss of smell NOT inclined to do?

• A. Use more spices in their food
• B. Eat less food
• C. Eat and drink more sweets
• D. Lose weight

Correct answer: D

Rationale: Individuals with a loss of smell are typically inclined to eat less because the enjoyment of food is diminished due to the lack of taste. However, they may compensate for this loss by consuming more sweets or using more spices. Therefore, they are less inclined to lose weight because of the increased consumption of sweets and spices, not because they eat less. Choice 'A' is incorrect because individuals with loss of smell often use more spices to enhance the taste of their food. Choice 'B' is incorrect as they may indeed eat less due to the diminished enjoyment of food. Choice 'C' is also incorrect as they tend to eat and drink more sweets to compensate for their loss of taste.

4. A client with pre-dialysis end-stage kidney disease is being taught about diet. Which of the following instructions should the nurse include?

• A. Increase intake of dietary phosphorus.
• B. Eliminate foods high in protein from your diet.
• C. Reduce intake of foods high in potassium.
• D. Increase intake of sodium-containing foods.

Correct answer: C

Rationale: In pre-dialysis end-stage kidney disease, reducing intake of foods high in potassium is crucial as impaired kidney function can lead to potassium buildup in the blood, which can be dangerous. High potassium levels can cause irregular heartbeats and even cardiac arrest. Therefore, advising the client to reduce potassium-rich foods is essential to prevent complications. Choices A, B, and D are incorrect. Increasing dietary phosphorus, eliminating foods high in protein, or increasing sodium-containing foods are not appropriate recommendations for a client with pre-dialysis end-stage kidney disease as they can exacerbate the condition.

5. A nurse is initiating continuous enteral feedings for a client who has a new gastrostomy tube. Which of the following actions should the nurse take?

• A. Measure the client’s gastric residual every 12 hours.
• B. Obtain the client’s electrolyte levels every 4 hours.
• C. Keep the client’s head elevated at 15° during feedings.
• D. Flush the client’s tube with 30 mL of water every 4 hours.

Correct answer: D

Rationale: Flushing the client’s tube with 30 mL of water every 4 hours is essential to maintain tube patency and prevent blockages. This action helps ensure the continuous flow of enteral feedings without obstruction. Measuring the client’s gastric residual every 12 hours (Choice A) is important but not the priority when initiating enteral feedings. Obtaining the client’s electrolyte levels every 4 hours (Choice B) is unnecessary and not directly related to tube feeding initiation. Keeping the client’s head elevated at 15° during feedings (Choice C) is a good practice to prevent aspiration, but tube flushing is more crucial to prevent tube occlusion.

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