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 are intended for the general population and do not specifically address disease states, which are managed with different clinical guidelines. Choice A is correct as DRIs have replaced the older recommended daily allowances. Choice B is correct as current DRIs aim to estimate the required nutrients for long-term health. Choice D is correct as DRIs also attempt to establish maximum safe levels of tolerance for nutrients.

2. Mrs. Seva also tells the nurse that she is often constipated. Because she is aging, what physical changes predispose her to constipation?

• A. inhibition of the parasympathetic reflex
• B. weakness of sphincter muscles of anus
• C. loss of tone of the smooth muscles of the colon
• D. decreased ability to absorb fluids in the lower intestines

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

3. Each of the following foods has cariostatic properties, with one exception. Which food is the exception?

• A. Eggs
• B. Instant oatmeal
• C. Cheese
• D. Seafood

Correct answer: B

Rationale: Cariostatic foods are those that contribute to the prevention of tooth decay. Eggs, cheese, and seafood are all cariostatic foods, as they can aid in protecting against tooth decay. On the contrary, instant oatmeal does not possess these cariostatic properties. Due to its processed nature, it is more fermentable and cariogenic, which means it can encourage cavity formation. Although it is not directly harmful to the teeth, it does not provide the same defensive benefits against tooth decay as the other choices do. Therefore, 'Instant oatmeal' is the exception among these foods and is the correct answer.

4. What is the most appropriate nutritional advice for a patient with hypertension?

• A. Increase salt intake
• B. Reduce fiber intake
• C. Increase potassium intake
• D. Increase sugar intake

Correct answer: C

Rationale: Increasing potassium intake can help manage blood pressure levels in patients with hypertension.

5. What does oliguria lead to in patients with acute kidney injury?

• A. Hypophosphatemia and overgrowth of bone tissue
• B. An increase in blood potassium levels due to excessive excretion of parathyroid hormone
• C. Sodium retention and elevated levels of potassium
• D. Edema due to increased urine production

Correct answer: C

Rationale: In patients with acute kidney injury, oliguria (reduced urine output) often results in sodium retention and hyperkalemia (elevated levels of potassium). This is due to the kidneys' decreased capacity to excrete these substances. Choice A is incorrect because hypophosphatemia and overgrowth of bone tissue are not direct consequences of oliguria in acute kidney injury. Choice B is incorrect because an increase in blood potassium levels is not caused by excessive excretion of parathyroid hormone but rather by decreased excretion of potassium. Choice D is incorrect because edema is not caused by increased urine production but rather by fluid overload due to decreased urine output.

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