Nursing Elites

1. For a patient with celiac disease, which dietary modification is necessary?

• A. Increase protein intake
• B. Avoid gluten
• C. Increase dairy intake
• D. Avoid lactose

Correct answer: B

Rationale: The correct answer is B: Avoid gluten. Patients with celiac disease have an immune reaction to gluten, a protein found in wheat, barley, and rye. Therefore, it is crucial for individuals with celiac disease to avoid gluten-containing products. Increasing protein intake (Choice A) is not specifically necessary for celiac disease management. Increasing dairy intake (Choice C) is unrelated to the dietary requirements of individuals with celiac disease. Avoiding lactose (Choice D) is relevant for individuals with lactose intolerance, not celiac disease. Therefore, the only necessary modification for a patient with celiac disease is to avoid gluten.

2. Which group is least susceptible to insufficient intake of protein?

• A. The elderly
• B. Individuals with low income
• C. Adults participating in endurance exercise
• D. Patients who are chronically ill

Correct answer: C

Rationale: Adults who participate in endurance exercise are typically more aware of their nutritional needs and have higher protein intake compared to other groups. The rationale behind why the other choices are incorrect is as follows: A: The elderly are often at a higher risk of insufficient protein intake due to various factors such as reduced appetite, dental issues, and decreased muscle mass. B: Individuals with low income may struggle to afford protein-rich foods, making them more susceptible to insufficient protein intake. D: Patients who are chronically ill may have specific dietary restrictions or challenges that can lead to inadequate protein consumption.

3. Each of the following is a fat-soluble vitamin except for one. Which is the exception?

• A. Vitamin A
• B. Vitamin C
• C. Vitamin D
• D. Vitamin K

Correct answer: B

Rationale: The correct answer is B, Vitamin C. Vitamin C is a water-soluble vitamin, not fat-soluble. Fat-soluble vitamins are Vitamins A, D, E, and K. These vitamins are stored in the body's fat tissues and liver, unlike water-soluble vitamins which are not stored and are eliminated in urine, making them less likely to reach toxic levels.

4. 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.

5. A nurse is caring for a client who has a new prescription for a low-sodium diet. The client's family has requested to bring in some of the client's favorite foods. Which of the following food items should the nurse tell the family members to omit?

• A. Boiled rice
• B. Flat bread
• C. Broiled fish fillet
• D. Pickled vegetables

Correct answer: D

Rationale: The correct answer is 'Pickled vegetables.' Pickled vegetables are high in sodium due to the pickling process, making them unsuitable for a low-sodium diet. Boiled rice, flat bread, and broiled fish fillet are generally lower in sodium compared to pickled vegetables and can be included in a low-sodium diet. Therefore, the nurse should advise the family to omit pickled vegetables to adhere to the client's dietary restrictions.

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