Nursing Elites

1. Each of the following accurately describes aspects of the dietary reference intakes (DRIs) published by the Food and Nutrition Board of the Institute of Medicine (IOM) except one. Which one is the exception?

• A. The DRIs replace the older recommended daily allowances.
• B. Current DRIs attempt to estimate required nutrients to improve long-term health.
• C. DRIs specifically address individuals whose requirements are affected by a disease state.
• D. The DRIs attempt to establish maximum safe levels of tolerance for nutrients.

Correct answer: C

Rationale: The correct answer is C. DRIs do not specifically address individuals with disease states; they are intended for the general healthy population. Choice A is correct because DRIs indeed replace the older recommended daily allowances. Choice B is correct as current DRIs aim to estimate required nutrients to enhance long-term health. Choice D is accurate as DRIs also attempt to establish maximum safe levels of tolerance for nutrients.

2. Is it correct that eliminating sucrose from the diet leads to a significant reduction in dental caries, and that the best advice is to consume sugar in moderation and limit the frequency of sugar exposure?

• A. Both statements are true
• B. Both statements are false
• C. The first statement is true; the second is false
• D. The first statement is false; the second is true

Correct answer: D

Rationale: The first statement is incorrect because dental caries are not solely caused by sucrose. They are the result of a complex interaction of multiple factors, including the type of bacteria in the mouth, the host's diet, oral hygiene, and salivary flow. The second statement is correct as consuming sugar in moderation and limiting the frequency of sugar exposure are indeed effective strategies to prevent dental caries. Therefore, the answer is option D: The first statement is false; the second is true.

3. A client says to the nurse “I am worthless person, I should be dead” The nurse best replies:

• A. “Don’t say you are worthless, you are not a worthless person”
• B. “We are going to help you with your feelings”
• C. “What makes you feel you’re worthless?”
• D. “What you say is not true”

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

4. A client at risk for iron-deficiency anemia is being taught by a nurse about optimizing dietary intake of iron. The nurse should explain that which of the following sources of iron is easiest for the body to absorb?

• A. Spinach
• B. Cantaloupe
• C. Chicken
• D. Lentils

Correct answer: C

Rationale: The correct answer is 'Chicken.' Chicken contains heme iron, which is more easily absorbed by the body compared to non-heme iron found in plant-based sources like spinach, cantaloupe, and lentils. Heme iron, as present in chicken, is more bioavailable and is better absorbed by the body, making it an excellent source of iron for individuals at risk of iron-deficiency anemia. Spinach, cantaloupe, and lentils contain non-heme iron, which is not as efficiently absorbed as heme iron.

5. A client with frequent kidney stones is receiving dietary teaching from a nurse. Which of the following instructions should the nurse include?

• A. Limit your intake of dairy products.
• B. Increase your consumption of protein-rich foods.
• C. Avoid eating tree nuts, such as almonds.
• D. Take a vitamin C supplement twice daily.

Correct answer: A

Rationale: The correct answer is to instruct the client to limit their intake of dairy products. Dairy products are high in calcium and can contribute to kidney stone formation in susceptible individuals. Increasing protein intake may lead to higher excretion of calcium, which can exacerbate kidney stone formation. While tree nuts are high in oxalates, which can contribute to kidney stone formation, it is not the primary concern in this case. Vitamin C supplements can increase oxalate levels in the urine, potentially increasing the risk of kidney stone formation, so it should not be recommended.

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