Nursing Elites

1. Medication for treating high blood cholesterol levels should not be used for most people unless:

• A. The patient has at least three major risk factors for coronary heart disease
• B. The patient has been experiencing symptoms of coronary heart disease for at least three months
• C. The patient's medical insurance covers prescription drugs
• D. Treatment with Therapeutic Lifestyle Changes (TLC) alone is unsuccessful after three months

Correct answer: D

Rationale: The correct answer is choice D because medication for high cholesterol is typically not considered unless Therapeutic Lifestyle Changes (TLC), which include diet and exercise, have not proven effective after a three-month period. This approach ensures that lifestyle modifications are given a fair chance to lower cholesterol levels before resorting to medication. Choice A is incorrect because the number of risk factors for coronary heart disease does not dictate when to begin medication; it is about the effectiveness of lifestyle changes. Choice B is incorrect as the duration of coronary heart disease symptoms does not determine when to start medication; the focus is on the response to TLC. Choice C is incorrect because the coverage of prescription drugs by the patient's insurance does not influence the medical decision to use medication for high cholesterol; it is based on medical necessity and effectiveness of prior interventions.

2. Patients maintained using peritoneal dialysis may gain weight because:

• A. their appetite is increased
• B. physical activity is limited
• C. they absorb glucose from the dialysate
• D. they absorb amino acids from the dialysate

Correct answer: C

Rationale: Glucose from the peritoneal dialysis solution can be absorbed into the bloodstream, leading to weight gain if not balanced with diet and activity.

3. A nurse is caring for an antepartum client who has iron-deficiency anemia. When teaching the client about nutrition, the nurse should emphasize the need for an increased intake of which of the following foods?

• A. Milk and cheese
• B. Red meat and organ meat
• C. Fresh fruits
• D. Whole grain breads

Correct answer: B

Rationale: The correct answer is red meat and organ meat. These foods are rich sources of heme iron, which is more easily absorbed by the body compared to non-heme iron found in plant-based foods. Red meat and organ meat can significantly help in increasing the iron levels in individuals with iron-deficiency anemia, especially in antepartum clients. Fresh fruits, while nutritious, do not provide high amounts of iron. Milk and cheese are not the best sources of iron for individuals with iron-deficiency anemia. Whole grain breads also do not contain as much bioavailable iron as red meat and organ meat.

4. A nurse is instructing teenage girls on the importance of adequate calcium intake throughout their life span to prevent complications. Which complication should the nurse include in the teaching?

• A. Goiter
• B. Osteoporosis
• C. Heart disease
• D. Dental caries

Correct answer: B

Rationale: The correct answer is B: Osteoporosis. Adequate calcium intake throughout life helps prevent osteoporosis, a condition characterized by weak and brittle bones, which is common in older adults. Goiter is caused by an iodine deficiency, not calcium. Heart disease is more related to factors like cholesterol and blood pressure. Dental caries are primarily influenced by oral hygiene and sugar intake, not just calcium.

5. What is the recommended dietary intervention for a patient with hyperlipidemia?

• A. Increase saturated fat intake
• B. Reduce fiber intake
• C. Increase dietary fiber intake
• D. Reduce protein intake

Correct answer: C

Rationale: Increasing dietary fiber can help reduce cholesterol levels in patients with hyperlipidemia.

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