Nursing Elites

1. A nurse is teaching a group of adults about nutrition. The nurse should include which of the following amounts as an appropriate daily intake of fiber for adult women?

• A. 5 to 10 g
• B. 10 to 15 g
• C. 20 to 35 g
• D. 40 to 50 g

Correct answer: C

Rationale: The correct answer is 20 to 35 g. This range is the recommended daily intake of fiber for adult women. Fiber is essential for maintaining a healthy digestive system and overall well-being. Option A (5 to 10 g) is too low and may not provide sufficient fiber intake. Option B (10 to 15 g) is also below the recommended range. Option D (40 to 50 g) is too high and can lead to gastrointestinal discomfort and other complications if consumed in excess.

2. Which of the following terms refers to a process by which an individual receives education about the recognition of stress reactions and management strategies for handling stress, which may be instituted after a disaster?

• A. Critical incident stress management
• B. Follow-up
• C. Debriefing
• D. Defusion

Correct answer: A

Rationale: Critical incident stress management is a process that provides individuals with education about recognizing stress reactions and strategizing management techniques for handling stress after a disaster. Choice B, 'Follow-up', is incorrect because it generally refers to continuing care after initial treatment, not specifically to stress management education. Choice C, 'Debriefing', is a process where individuals involved in a critical event are brought together to discuss the event and their reactions to it. It can be part of the critical incident stress management process, but it doesn't cover the whole process. Choice D, 'Defusion', is a technique used in the immediate aftermath of a traumatic event to help individuals process their experiences, but it does not encompass the full range of education about stress recognition and management strategies.

3. Which suggestion is most appropriate to increase calorie intake for a patient with stomach cancer, aiming to prevent weight loss and wasting?

• A. Replace whole fat milk with skim milk or water
• B. Avoid peanut butter and other nuts
• C. Choose high-fat meat instead of lean meat
• D. Limit alcohol intake to two drinks per day

Correct answer: C

Rationale: The correct answer is C: Choose high-fat meat instead of lean meat. High-fat meats are more calorie-dense than lean meats, which makes them a good choice for increasing calorie intake. This is crucial for patients with stomach cancer who want to avoid weight loss and wasting. Choice A is incorrect because skim milk or water contains fewer calories than whole fat milk. Choice B is also incorrect because peanut butter and nuts are high in calories and therefore should not be avoided when trying to increase calorie intake. Finally, choice D is not a good suggestion to increase calorie intake as alcohol does not provide the necessary nutrients needed for a balanced diet. In fact, excessive alcohol can harm the liver and other organs, and it's not a reliable source of calories.

4. 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.

5. What happens when Mrs. Guevarra, a nurse, delegates aspects of the client's care to the nurse-aide, an unlicensed staff member?

• A. Mrs. Guevarra makes the assignment to instruct the staff member
• B. Mrs. Guevarra is assigning the responsibility to the aide but not the accountability for those tasks
• C. Mrs. Guevarra does not need to directly supervise or evaluate the aide
• D. Mrs. Guevarra must know how to perform the task being delegated

Correct answer: C

Rationale: The correct answer is C. While it is true that Mrs. Guevarra is delegating tasks to the nurse-aide, she does not necessarily have to directly supervise or evaluate the aide. She still retains the overall accountability for the care of the client, but direct supervision of the aide is not a requirement for delegation. Choice A is incorrect because the primary purpose of delegation is not instruction. Choice B is also incorrect because although Mrs. Guevarra is delegating tasks, she still retains accountability for those tasks. Finally, choice D is incorrect because the ability to perform the task being delegated is not a requirement for the delegator; the delegatee should have the necessary skills and knowledge to perform the delegated tasks.

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