Nursing Elites

1. Clients may benefit from slightly higher fat intakes than are normally recommended if they have:

• A. congestive heart failure
• B. cerebrovascular accident
• C. peripheral vascular disease
• D. chronic obstructive pulmonary disease

Correct answer: D

Rationale: In chronic obstructive pulmonary disease (COPD), higher fat intake can be beneficial because it provides more calories with less respiratory burden compared to carbohydrates. Choices A, B, and C are incorrect because congestive heart failure, cerebrovascular accident, and peripheral vascular disease do not specifically benefit from higher fat intakes as in COPD.

2. Patients with kidney stones should increase their intake of:

• A. fluids
• B. vitamin C
• C. oxalates
• D. protein

Correct answer: A

Rationale: Patients with kidney stones should increase their intake of fluids. Increasing fluid intake helps to dilute the urine and reduce the risk of kidney stones forming by flushing out minerals that can crystallize. This promotes the passage of small stones and helps prevent the formation of new ones. Vitamin C and protein intake should be moderated as excessive consumption may lead to the formation of certain types of kidney stones. Oxalates should be limited in the diet as they can contribute to the formation of calcium oxalate stones, a common type of kidney stone.

3. A client who is 2 days postoperative following abdominal surgery is about to progress from a clear liquid diet to full liquids. Which of the following items should the nurse tell the client he may now request to have on his meal tray?

• A. Cranberry juice
• B. Flavored gelatin
• C. Skim milk
• D. Chicken broth

Correct answer: A

Rationale: Cranberry juice is an appropriate choice for a client transitioning from a clear liquid diet to full liquids post abdominal surgery. It provides hydration and some essential nutrients. Flavored gelatin is usually allowed on a clear liquid diet and may not be suitable for a full liquids phase. Skim milk and chicken broth are typically introduced in a later stage of the diet progression, closer to a soft diet, due to their higher protein and fat content.

4. 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.

5. Among people who are ill, significant weight loss may be masked by?

• A. dehydration
• B. a large tumor
• C. drug therapy
• D. fluid retention

Correct answer: D

Rationale: Fluid retention can mask weight loss in ill individuals as the retained fluid adds to body weight, making it difficult to detect true fat or muscle loss. Dehydration (Choice A) would actually lead to weight loss rather than masking it. While a large tumor (Choice B) could contribute to weight loss, it would not mask the weight loss itself. Drug therapy (Choice C) may cause side effects, including weight changes, but it is unlikely to mask significant weight loss in the same way that fluid retention does.

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