Nursing Elites

1. For a patient on a ketogenic diet, which macronutrient is primarily increased?

• A. Carbohydrates
• B. Protein
• C. Fats
• D. Fiber

Correct answer: C

Rationale: The correct answer is C: Fats. A ketogenic diet is characterized by high fat intake, moderate protein intake, and very low carbohydrate intake. This diet aims to shift the body's metabolism to use fat as the primary source of energy instead of carbohydrates. Increasing fat intake while reducing carbohydrates is essential for achieving and maintaining a state of ketosis. Therefore, choices A, B, and D are incorrect as they do not align with the macronutrient adjustments required for a ketogenic diet.

2. Which food items should be avoided by a child with lactose intolerance?

• A. Popcorn, seeds, and any foods containing nuts.
• B. Milk, cheese, ice cream, and puddings.
• C. Wheat, rye, barley, and commercially baked goods.
• D. Eggs, ham, bacon, and canned meats.

Correct answer: B

Rationale: The correct answer is B: Milk, cheese, ice cream, and puddings should be avoided by a child with lactose intolerance because they contain lactose, which the child's body may have difficulty digesting. Option A is incorrect as popcorn, seeds, and foods containing nuts do not typically contain lactose. Option C lists wheat, rye, barley, and commercially baked goods, which are sources of gluten, not lactose. Option D includes eggs, ham, bacon, and canned meats, which are also not sources of lactose. Therefore, B is the most appropriate choice for a child with lactose intolerance.

3. Mr. CKK is unconscious and was brought to the E.R. Who among the following can give consent for CKK's operation?

• A. Doctor
• B. Nurse
• C. Next of Kin
• D. The Patient

Correct answer: A

Rationale: In the scenario described, when a patient is unconscious and unable to provide consent, the responsibility usually falls on the physician to make decisions regarding the patient's treatment, including obtaining consent for an operation. While nurses play a crucial role in patient care, they typically do not have the authority to provide consent for a major procedure. The next of kin may be consulted for input, but the ultimate decision-making authority lies with the physician. The patient, being unconscious, is unable to provide consent in this situation.

4. A community health nurse is conducting a class on what to expect during pregnancy. What instruction should the nurse include on weight gain?

• A. Failure to obtain the required weight gain during pregnancy will increase the risk of preterm birth.
• B. An obese client should not gain as much weight as a client with a normal body mass index.
• C. A client with a normal body mass index should plan on gaining 50 pounds.
• D. Clients do not need to eat for two when they are pregnant.

Correct answer: A

Rationale: Adequate weight gain during pregnancy is essential as failure to obtain the required weight gain can increase the risk of preterm birth. Choice B is incorrect because it is important for obese clients to gain an appropriate amount of weight during pregnancy, not the same as those with a normal body mass index. Choice C is incorrect as gaining 50 pounds for a client with a normal body mass index is excessive. Choice D is incorrect as the common saying 'eating for two' during pregnancy is a misconception; pregnant individuals do not need to double their caloric intake.

5. Which enzyme is most essential for hydrolyzing large protein molecules?

• A. Gastric lipase
• B. Pepsin
• C. Mucus
• D. Intrinsic factor

Correct answer: B

Rationale: Pepsin, choice B, is the correct answer as it is a proteolytic enzyme that is essential for the breakdown of large protein molecules in the stomach. Gastric lipase, choice A, is incorrect because it primarily targets fats, not proteins, hence it is not involved in protein hydrolysis. Mucus, choice C, is incorrect as it serves to protect the stomach lining from acidic gastric juices and does not play a direct role in protein digestion. Intrinsic factor, choice D, is incorrect as it is vital for the absorption of Vitamin B12 in the small intestine and doesn't participate in the process of hydrolyzing proteins.

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