Nursing Elites

1. All of the following are instructions for proper foot care to be given to a client with peripheral vascular disease caused by diabetes. Which one is not?

• A. Trim nails using a nail clipper
• B. Apply cornstarch to the foot
• C. Always check the temperature of the water before bathing
• D. Use canvas shoes

Correct answer: A

Rationale: The correct answer is 'A', which says trim nails using a nail clipper. This is incorrect because patients with peripheral vascular disease, particularly those caused by diabetes, should not trim their nails themselves due to the risk of injury, infection, and poor wound healing. The other options, 'B', 'C', and 'D', are correct advice for diabetic foot care. Applying cornstarch can help keep the feet dry and prevent fungal infections. Checking the water temperature before bathing can prevent burns, as patients with peripheral vascular disease often have decreased sensation in their feet. Wearing canvas shoes can improve foot ventilation and reduce the risk of foot ulcers and infections.

2. Which breakfast item should be recommended for a vegan adolescent to combine protein?

• A. Bagel with cream cheese
• B. Wheat toast with jelly
• C. Oatmeal pancakes with peanut butter
• D. Eggs with tofu bacon

Correct answer: C

Rationale: Oatmeal pancakes with peanut butter provide a protein combination suitable for a vegan diet.

3. The nurse understands that malnutrition is a prevalent issue among hospitalized individuals. What is it commonly associated with?

• A. Decreased health care expenses
• B. Elevated blood pressure
• C. Decreased mortality rates
• D. A compromised immune system

Correct answer: D

Rationale: Malnutrition is often associated with a weakened immune system. This is because when the body is not sufficiently nourished, it lacks the necessary nutrients to maintain a well-functioning immune system, making patients more vulnerable to infections and other health complications. This can potentially increase mortality rates and prolong hospital stays, contrary to choice C. Choices A and B are incorrect as malnutrition does not lead to decreased health care costs or high blood pressure. In fact, it may increase health care costs due to the potential for increased complications and extended hospital stays.

4. A nurse is providing MyPlate education to a client newly diagnosed with diabetes mellitus. Which plate chosen by the client indicates the teaching was effective, according to the MyPlate guidelines?

• A. 1/2 of the plate is filled with carbohydrate foods, 1/4 filled with protein foods, and 1/4 filled with fruits and vegetables
• B. 1/2 of the plate is filled with protein foods, 1/4 filled with carbohydrates, and 1/4 filled with non-starchy vegetables
• C. 1/2 of the plate is filled with carbohydrates, 1/4 filled with protein foods, and 1/4 filled with non-starchy vegetables
• D. 1/2 of the plate is filled with non-starchy vegetables, 1/4 filled with protein foods, and 1/4 filled with carbohydrate foods

Correct answer: D

Rationale: The correct answer is D. This option reflects the MyPlate guidelines for managing diabetes effectively. In diabetes management, it is essential to focus on non-starchy vegetables, appropriate protein portions, and controlled carbohydrate intake. Option A places too much emphasis on carbohydrates, which may not be suitable for diabetes. Option B swaps the proportions of protein and carbohydrates, which is not in line with the recommended distribution. Option C places too much emphasis on carbohydrates and lacks the emphasis on non-starchy vegetables, making it less suitable for diabetes management.

5. While evaluating the meal choices of a client with major depressive disorder and a prescription of Phenelzine, which of the following selections should the nurse identify as appropriate?

• A. Cheddar cheese
• B. Smoked salmon
• C. Strawberry yogurt
• D. Pepperoni pizza

Correct answer: C

Rationale: The correct answer is C, 'Strawberry yogurt.' This choice is appropriate because it does not contain high levels of tyramine, which can lead to a dangerous interaction with Phenelzine, a monoamine oxidase inhibitor. Tyramine-rich foods, like aged cheeses (such as cheddar cheese) and cured meats (like smoked salmon and pepperoni), should be avoided by individuals taking Phenelzine to prevent hypertensive crisis. Strawberry yogurt is a safer option for the client in this scenario.

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