Nursing Elites

1. Which of the following suggestions is the healthiest for Miguel, who is always hungry and never seems to feel full despite eating enough calories?

• A. Switch out energy-dense foods with more nutrient-dense foods that are more likely to make him feel full
• B. Drink adequate amounts of water
• C. A, B
• D. Eat foods with more fat, as fat slows gastric emptying and will make him feel more full

Correct answer: C

Rationale: The correct answer is A and B. Switching to more nutrient-dense foods can help Miguel feel full despite eating enough calories. Nutrient-dense foods provide essential nutrients and are more satisfying. Drinking adequate water is also crucial for overall health and can help with feelings of fullness. Choice D is incorrect because while fat can contribute to satiety, it should be consumed in balance with other nutrients. Consuming foods with high fat content excessively may lead to other health issues and does not address the underlying problem of feeling constantly hungry despite eating.

2. Which of the following is reflected in an ECG due to hypokalemia?

• A. Tall T waves and Pathologic Q wave
• B. Widening QRS Complex and U wave
• C. None of the above
• D. Both A and B

Correct answer: B

Rationale: Hypokalemia, a condition characterized by low levels of potassium in the blood, is reflected in an ECG by a widening QRS Complex and a U wave. This is because potassium plays a key role in the electrical activity of the heart, and its deficiency can lead to abnormalities in the heart's rhythm as represented by these specific changes on the ECG. Choice A is incorrect as tall T waves and pathologic Q waves are more commonly associated with hyperkalemia or myocardial infarction, respectively, rather than hypokalemia. Choices C and D are also incorrect as they do not accurately reflect the ECG changes caused by hypokalemia.

3. What is the best snack choice for a preschool-age child?

• A. Fruit snacks
• B. Mini wheat bagel with peanut butter
• C. White toast with jelly
• D. Sports drink

Correct answer: B

Rationale: The best snack choice for a preschool-age child is a mini wheat bagel with peanut butter as it provides a good balance of carbohydrates, protein, and healthy fats. Fruit snacks, although they contain some fruit flavor, are often high in added sugars and lack essential nutrients. White toast with jelly may provide quick energy but lacks protein and healthy fats, which are important for a balanced snack choice. Sports drinks are typically high in sugar and unnecessary for a preschool-age child's snack, as they are designed for rehydration during intense physical activity, not as a regular snack option.

4. What should Mrs. Smith do to increase her HDL levels, as advised by the nurse?

• A. Monitor her blood glucose levels
• B. Quit smoking
• C. Control her blood pressure
• D. Take fish oil supplements

Correct answer: B

Rationale: The correct answer is 'Quit smoking.' Smoking has been shown to lower HDL (High-Density Lipoprotein) levels, and quitting can help to improve these levels. HDL is often referred to as 'good cholesterol' because it helps to remove other forms of cholesterol from the bloodstream, reducing the risk of heart disease. While monitoring blood glucose levels, controlling blood pressure, and taking fish oil supplements can contribute to overall health and wellbeing, they do not directly increase HDL levels in the same way that quitting smoking does. Therefore, quitting smoking is the most effective way for Mrs. Smith to increase her HDL levels as advised by the nurse.

5. A nurse is planning care for a toddler who has burns over 50% total body surface area. Which of the following actions should the nurse include in the plan of care?

• A. Administer enteral feedings
• B. Limit intake of vitamin C
• C. Limit dietary protein
• D. Administer insulin prior to meals

Correct answer: A

Rationale: Administering enteral feedings is crucial for ensuring adequate nutrition and supporting healing in toddlers with extensive burns. Burns over 50% total body surface area can lead to increased metabolic demands, making it essential to provide nutrition through enteral feedings to meet the child's needs for healing and recovery. Limiting intake of vitamin C or dietary protein would be detrimental in this scenario as the child requires increased amounts of nutrients to support healing. Administering insulin prior to meals is not indicated in this case as the priority is to provide adequate nutrition to promote healing.

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