Nursing Elites

1. Nutrition therapy for clients with diabetes is based on:

• A. low dietary intake of sugars
• B. standardized diabetic diet plans
• C. each client’s lifestyle and preferences
• D. the client’s weight and blood glucose level

Correct answer: C

Rationale: Corrected Rationale: Nutrition therapy for clients with diabetes should be individualized to each client's lifestyle, preferences, and needs. This approach ensures that the dietary plan is sustainable and tailored to the client, leading to better adherence and improved health outcomes. Choices A and B are too general and do not account for individual differences among clients. Choice D, focusing solely on weight and blood glucose levels, overlooks other crucial aspects of a client's overall well-being and dietary requirements in diabetes management.

2. Miss CEE is admitted for treatment of major depression. She appears withdrawn, disheveled, and states 'Nobody wants me'. What does the nurse most likely expect that Miss CEE is to be placed on?

• A. Neuroleptics medication
• B. Special diet
• C. Suicide precaution
• D. Anxiolytics medication

Correct answer: C

Rationale: Given Miss CEE's state of major depression and her expressed feelings of worthlessness ('Nobody wants me'), the nurse would most likely expect her to be placed on suicide precaution. This means that measures would be taken to ensure her safety and to prevent her from harming herself. While medications like neuroleptics (Choice A) and anxiolytics (Choice D) might be employed as part of her overall treatment, these medicines are primarily used for conditions like psychosis and anxiety respectively, not specifically for depression or suicidal ideation. A special diet (Choice B) may be part of a comprehensive treatment plan, but it is not as immediate or as directly related to her current emotional and psychological state as suicide precaution is.

3. Which statement indicates understanding of a low-fiber diet?

• A. I can cut up carrots and celery sticks for my lunch.
• B. I will eat a bran muffin for my mid-morning snack.
• C. I will have oatmeal with skim milk for my breakfast.
• D. I should choose canned peaches for my fruit serving.

Correct answer: D

Rationale: The correct answer is D because canned peaches are low in fiber compared to the other options provided. Option A contains high-fiber vegetables (carrots and celery), option B includes a bran muffin which is fiber-rich, and option C involves oatmeal which is also a good source of fiber. Therefore, choosing canned peaches aligns with a low-fiber diet.

4. 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.

5. Who most often prescribes a patient's diet order?

• A. Registered Nurse
• B. Physician
• C. Registered Dietetic Technician
• D. Occupational Therapist

Correct answer: B

Rationale: A patient's dietary order is most frequently prescribed by a physician. This is because the physician has a comprehensive understanding of the patient's medical condition and can thus determine the most suitable dietary plan. Registered dietitians often collaborate with physicians in this process, but the final prescription is made by the physician. Although registered nurses, dietetic technicians, and occupational therapists play significant roles in patient care, they typically do not prescribe diet orders.

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