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. A nurse is caring for a client who is receiving parenteral nutrition. Which of the following findings indicates the therapy is effective?

• A. Client has soft, formed bowel movements.
• B. Client’s mucous membranes are pink.
• C. Client reports ability to complete ADLs.
• D. Client’s blood glucose level is within the expected reference range.

Correct answer: D

Rationale: The correct answer is D because having a blood glucose level within the expected reference range indicates that parenteral nutrition is effectively meeting the client's nutritional needs. Choices A, B, and C are incorrect because soft, formed bowel movements, pink mucous membranes, and the ability to complete activities of daily living do not directly reflect the effectiveness of parenteral nutrition therapy.

3. Select all that apply. To lower LDL levels, you should:

• A. consume minimal amounts of hydrogenated and saturated fats
• B. consume more insoluble fibers than soluble fibers
• C. consume alcohol in moderate levels
• D. engage in regular physical activity

Correct answer: A

Rationale: To lower LDL levels, reducing intake of hydrogenated (trans) and saturated fats is crucial, as these types of fats can raise LDL cholesterol in the blood. Choice B is incorrect because both soluble and insoluble fibers can help lower LDL levels. Choice C is incorrect as excessive alcohol consumption can lead to increased LDL levels. Choice D, engaging in regular physical activity, can help raise HDL (good) cholesterol levels but is not directly related to lowering LDL levels.

4. While a team effort is necessary in the operating room (OR) for efficient and quality patient care delivery, the number of people in the room should be limited for infection control purposes. Which roles comprise this team?

• A. Surgeon, anesthesiologist, scrub nurse, radiologist, orderly
• B. Surgeon, assistants, scrub nurse, circulating nurse, anesthesiologist
• C. Surgeon, assistant surgeon, anesthesiologist, scrub nurse, pathologist
• D. Surgeon, assistant surgeon, anesthesiologist, intern, scrub nurse

Correct answer: B

Rationale: The roles typically present in an operating room team include the surgeon, assistants (which may include an assistant surgeon), scrub nurse, circulating nurse, and anesthesiologist. These roles are directly involved in the operation and patient care. Choice B is correct. Choice A includes a radiologist and an orderly, who are not typically part of the immediate surgical team in the OR. Choice C includes a pathologist, who usually works in a laboratory outside of the OR. Choice D includes an intern, who may or may not be part of the team, depending on the specific circumstances and hospital policy. These explanations make choices A, C, and D incorrect.

5. What is the most important concern immediately after a myocardial infarction?

• A. Reducing cholesterol intake
• B. Allowing cardiac rest for healing
• C. Reducing saturated fat intake
• D. Eating several small meals each day

Correct answer: B

Rationale: Immediately after a myocardial infarction, the primary concern is to allow the heart to rest and heal to prevent further damage. This is why choice B is the correct answer. While choices A, C, and D might be a part of the long-term management plan following a myocardial infarction, they are not the immediate priority. Reducing cholesterol and saturated fat intake, as well as adjusting eating habits can help prevent future heart issues, but do not directly contribute to the immediate recovery post-myocardial infarction.

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