Nursing Elites

1. Lynn is an older adult who lives alone and has requested advice on how to eat a nutritious diet as cheaply as possible. One useful, practical tip for Lynn might be to _____.

• A. buy just a few pieces of fresh fruit at a time, in different stages of ripeness
• B. choose small boxes of frozen vegetables instead of large bags
• C. purchase pre-sliced or shredded cheese rather than whole pieces
• D. avoid buying certain foods in bulk, such as beans or dried legumes

Correct answer: A

Rationale: Buying a few pieces of fresh fruit at different stages of ripeness ensures that Lynn will have ripe fruit available over several days, reducing waste and cost. Choice B focuses on frozen vegetables but doesn't address the variety and ripeness factor like Choice A. Choice C is about cheese, which may not be as essential for a nutritious diet compared to fresh fruit. Choice D suggests avoiding certain foods in bulk, which might not be as relevant for maintaining a nutritious diet economically as the strategy in Choice A.

2. Patients with kidney stones should increase their intake of:

• A. fluids
• B. vitamin C
• C. oxalates
• D. protein

Correct answer: A

Rationale: Patients with kidney stones should increase their intake of fluids. Increasing fluid intake helps to dilute the urine and reduce the risk of kidney stones forming by flushing out minerals that can crystallize. This promotes the passage of small stones and helps prevent the formation of new ones. Vitamin C and protein intake should be moderated as excessive consumption may lead to the formation of certain types of kidney stones. Oxalates should be limited in the diet as they can contribute to the formation of calcium oxalate stones, a common type of kidney stone.

3. A nurse is caring for a client who is to receive a mechanically altered diet. Which of the following client food choices necessitates intervention by the nurse?

• A. Scrambled eggs
• B. Cottage cheese
• C. Piece of wheat toast
• D. Sliced banana

Correct answer: D

Rationale: The correct answer is 'Sliced banana.' A mechanically altered diet is designed for clients who have difficulty chewing or swallowing. Sliced bananas, due to their texture and potential choking hazard for clients with swallowing difficulties, would necessitate intervention by the nurse. Scrambled eggs, cottage cheese, and a piece of wheat toast are softer and safer options for clients on a mechanically altered diet, making them appropriate choices.

4. A client who is in her second trimester of pregnancy should increase her caloric intake by how many calories during this trimester?

• A. 110 cal/day
• B. 225 cal/day
• C. 340 cal/day
• D. 450 cal/day

Correct answer: C

Rationale: During the second trimester of pregnancy, it is recommended that a client increases their caloric intake by around 340 calories per day to support the growing needs of both the mother and the developing fetus. This additional intake helps ensure the proper nutrition and energy levels required during this crucial stage of pregnancy. Option A (110 cal/day) is too low to meet the increased demands. Option B (225 cal/day) is also below the recommended amount. Option D (450 cal/day) is higher than necessary and could lead to excessive weight gain, which is not ideal during pregnancy.

5. A nurse is planning care for a client who has ascites secondary to liver disease. Which of the following interventions should the nurse include in the plan of care?

• A. Reduce complex carbohydrates to 30% of total calories.
• B. Restrict protein intake to less than 0.8 g/kg/day.
• C. Decrease daily caloric intake by 20%.
• D. Limit sodium to 2000 mg or less per day.

Correct answer: D

Rationale: The correct answer is to limit sodium to 2000 mg or less per day. Ascites, which is the abnormal accumulation of fluid in the abdominal cavity, is commonly associated with liver disease. Limiting sodium intake helps manage fluid retention by reducing the fluid accumulation in the abdomen. Choices A, B, and C are incorrect because reducing complex carbohydrates, restricting protein intake, or decreasing caloric intake are not the primary interventions for managing ascites in liver disease.

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