Nursing Elites

1. Who most often prescribes a patient's diet order?

• A. Registered Nurse
• B. Physician
• C. Registered Dietetic Technician
• D. Occupational Therapist

Correct answer: B

Rationale: A patient's dietary order is most frequently prescribed by a physician. This is because the physician has a comprehensive understanding of the patient's medical condition and can thus determine the most suitable dietary plan. Registered dietitians often collaborate with physicians in this process, but the final prescription is made by the physician. Although registered nurses, dietetic technicians, and occupational therapists play significant roles in patient care, they typically do not prescribe diet orders.

2. 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.

3. Mario listens to Richard’s bilateral sounds and finds that congestion is in the upper lobes of the lungs. The appropriate position to drain the anterior and posterior apical segments of the lungs when Mario does percussion would be:

• A. Client lying on his back then flat on his abdomen on Trendelenburg position
• B. Client seated upright in bed or on a chair then leaning forward in sitting position then flat on his back and on his
• C. Client lying flat on his back and then flat on his abdomen
• D. Client lying on his right then left side on Trendelenburg position

Correct answer: A

Rationale: Proper patient positioning is essential for maximizing lung expansion and promoting the drainage of secretions. Postural drainage techniques rely on gravity to help clear different lung segments, which is critical in preventing complications such as atelectasis or pneumonia in immobilized patients.

4. What is a likely effect on a patient whose lab results reveal hypoalbuminemia?

• A. Infection
• B. Rickets
• C. Hypertension
• D. Edema

Correct answer: D

Rationale: Hypoalbuminemia, which refers to low albumin levels in the blood, is often associated with edema. Albumin helps maintain oncotic pressure, which keeps fluid within blood vessels. When albumin levels are low, this pressure decreases, leading to fluid leakage from the blood vessels into the surrounding tissues, resulting in edema. The other choices are less likely effects of hypoalbuminemia. Hypoalbuminemia doesn't directly cause infections (Choice A), rickets (Choice B) caused by vitamin D deficiency, or hypertension (Choice C) associated with factors like high sodium intake, obesity, and genetic predisposition.

5. High intakes of which of the following interfere with copper absorption and can lead to a deficiency?

• A. chromium
• B. sodium
• C. zinc
• D. manganese

Correct answer: C

Rationale: The correct answer is C, zinc. High intakes of zinc can interfere with copper absorption, potentially leading to copper deficiency. Copper is essential for various bodily functions, including iron metabolism. Choice A, chromium, is incorrect because chromium does not interfere with copper absorption. Choice B, sodium, and Choice D, manganese, are also incorrect as they do not interfere with copper absorption.

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