Nursing Elites

1. James wants to know the recommended intake for iron for his gender and age. Which of the following would provide the best answer for James?

• A. EAR
• B. UL
• C. RDA
• D. DV

Correct answer: C

Rationale: The Recommended Dietary Allowance (RDA) is the correct answer for James because it provides the daily intake level that meets the nutrient needs of most healthy individuals in a specific age and gender group. Choice A, EAR (Estimated Average Requirement), represents the average daily nutrient intake level estimated to meet the requirement of half the healthy individuals in a particular life stage and gender group. Choice B, UL (Tolerable Upper Intake Level), is the maximum daily intake unlikely to cause adverse health effects. Choice D, DV (Daily Value), is a general guide used for food labeling that represents how much a nutrient in a serving of food contributes to a daily diet based on a 2000-calorie daily intake.

2. Which bond is formed by a positively charged metal ion and negatively charged nonmetal ion?

• A. Ionic bond
• B. Covalent bond
• C. Functional group
• D. Metallic bond

Correct answer: A

Rationale: The correct answer is an ionic bond. An ionic bond is formed when a positively charged metal ion joins with a negatively charged nonmetal ion, resulting in a transfer of electrons. In contrast, a covalent bond involves sharing electrons between atoms rather than complete transfer. Functional groups are specific groups of atoms within molecules that determine the molecule's chemical properties. Metallic bonds occur between metal atoms where electrons are shared across a delocalized electron cloud.

3. A nurse is initiating continuous enteral feedings for a client who has a new gastrostomy tube. Which of the following actions should the nurse take?

• A. Measure the client’s gastric residual every 12 hours.
• B. Obtain the client’s electrolyte levels every 4 hours.
• C. Keep the client’s head elevated at 15° during feedings.
• D. Flush the client’s tube with 30 mL of water every 4 hours.

Correct answer: D

Rationale: Flushing the client’s tube with 30 mL of water every 4 hours is essential to maintain tube patency and prevent blockages. This action helps ensure the continuous flow of enteral feedings without obstruction. Measuring the client’s gastric residual every 12 hours (Choice A) is important but not the priority when initiating enteral feedings. Obtaining the client’s electrolyte levels every 4 hours (Choice B) is unnecessary and not directly related to tube feeding initiation. Keeping the client’s head elevated at 15° during feedings (Choice C) is a good practice to prevent aspiration, but tube flushing is more crucial to prevent tube occlusion.

4. Each statement is true of rickets, except one. Which is the exception?

• A. Rickets is being diagnosed more frequently in the United States.
• B. Rickets is caused by vitamin C deficiency.
• C. Tachetic deformities such as bow legs or knock-knees develop.
• D. A narrow and distorted chest occurs.

Correct answer: B

Rationale: Rickets is caused by vitamin D deficiency, not vitamin C deficiency. It usually occurs in children who are 1 to 3 years old. The name rickets came from the word 'wrikken,' meaning 'to bend or twist.' Common manifestations of rickets include tachetic deformities like bow legs or knock-knees, a narrow and distorted chest, and failure of the epiphyses of bones to develop normally, resulting in twisted and warped bones. While the diagnosis of rickets may be increasing in the United States, it is not caused by a lack of vitamin C.

5. A nurse is caring for a client following a CVA and observes the client experiencing severe dysphagia. The nurse notifies the provider. Which of the following nutritional therapies will likely be prescribed?

• A. NPO until dysphagia subsides
• B. Supplements via nasogastric tube
• C. Initiation of total parenteral nutrition
• D. Soft residue diet

Correct answer: B

Rationale: In the scenario of severe dysphagia following a CVA, the client may have difficulty swallowing and require alternative nutritional support. Providing supplements via a nasogastric tube allows for the delivery of essential nutrients directly into the stomach, bypassing the swallowing difficulties. NPO (nothing by mouth) until dysphagia subsides may be too restrictive for the client's nutritional needs. Initiation of total parenteral nutrition is usually reserved for cases where enteral feeding is not possible or contraindicated. A soft residue diet may not be suitable for a client experiencing severe dysphagia.

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