Nursing Elites

1. The home health nurse visits older adult clients at an assisted living center. Which foods should the nurse recommend to correct the main nutrient deficits for this population?

• A. Carbohydrates
• B. Oily fish and krill oil
• C. Yellow vegetables
• D. Dairy products

Correct answer: D

Rationale: The correct answer is D: Dairy products. Older adults are often deficient in calcium and vitamin D, which are abundant in dairy products. These nutrients are essential for maintaining bone health. Choice A (Carbohydrates) is incorrect because while carbohydrates are an essential nutrient, they are not specifically addressing the main nutrient deficits for older adults. Choice B (Oily fish and krill oil) is incorrect as these foods are sources of omega-3 fatty acids and not specifically addressing the main nutrient deficits common in older adults. Choice C (Yellow vegetables) is incorrect because although vegetables are important for overall health, they do not directly address the main nutrient deficits typically seen in older adults.

2. A nurse is providing MyPlate education to a client newly diagnosed with diabetes mellitus. Which plate chosen by the client indicates the teaching was effective, according to the MyPlate guidelines?

• A. 1/2 of the plate is filled with carbohydrate foods, 1/4 filled with protein foods, and 1/4 filled with fruits and vegetables
• B. 1/2 of the plate is filled with protein foods, 1/4 filled with carbohydrates, and 1/4 filled with non-starchy vegetables
• C. 1/2 of the plate is filled with carbohydrates, 1/4 filled with protein foods, and 1/4 filled with non-starchy vegetables
• D. 1/2 of the plate is filled with non-starchy vegetables, 1/4 filled with protein foods, and 1/4 filled with carbohydrate foods

Correct answer: D

Rationale: The correct answer is D. This option reflects the MyPlate guidelines for managing diabetes effectively. In diabetes management, it is essential to focus on non-starchy vegetables, appropriate protein portions, and controlled carbohydrate intake. Option A places too much emphasis on carbohydrates, which may not be suitable for diabetes. Option B swaps the proportions of protein and carbohydrates, which is not in line with the recommended distribution. Option C places too much emphasis on carbohydrates and lacks the emphasis on non-starchy vegetables, making it less suitable for diabetes management.

3. What describes a criterion used to diagnose diabetes?

• A. a plasma glucose concentration of 100 mg/dL or higher after a fast of at least 12 hours
• B. a casual blood sample of 200 mg/dL or higher in a person with classic symptoms
• C. a plasma glucose concentration measured two hours after a 200-gram glucose load is 400 mg/dL or higher
• D. a HbA1C higher than 5 percent

Correct answer: B

Rationale: A casual blood sample of 200 mg/dL or higher in a person with classic symptoms is a diagnostic criterion for diabetes. This choice aligns with the typical clinical presentation of diabetes and is a key diagnostic indicator. Choices A, C, and D do not accurately reflect the established criteria for diagnosing diabetes, making them incorrect. Choice A pertains to a fasting plasma glucose level, Choice C involves a glucose challenge test, and Choice D refers to HbA1C levels, which are used for monitoring blood sugar control over time, not for diagnosing diabetes.

4. The purpose of chest percussion and vibration is to loosen secretions in the lungs. The difference between the procedures is:

• A. Percussion uses only one hand, while vibration uses both hands
• B. Percussion delivers cushioned blows to the chest with cupped palms, while vibration gently shakes secretions loose
• C. In both percussion and vibration, the hands are not on top of each other, and hand action is not in tune with the client's breath
• D. Percussion slaps the chest to loosen secretions, while vibration shakes the secretions along with the inhalation

Correct answer: D

Rationale: Chest percussion involves the use of rhythmic tapping to dislodge mucus from the lungs, facilitating its movement toward the larger airways where it can be expelled. This technique is particularly important in conditions where mucus retention is a significant risk factor for infection. The key difference between chest percussion and vibration is that percussion involves slapping the chest to loosen secretions, while vibration involves shaking the secretions along with the inhalation, aiding in moving the loosened secretions upwards for easier removal. Choices A, B, and C do not accurately describe the main difference between chest percussion and vibration, making them incorrect.

5. A nurse is caring for a client following an appendectomy. The nurse verifies the postoperative prescription which reads, 'Discontinue NPO status; advance diet as tolerated.' Which of the following are appropriate for the nurse to offer the client? (SATA)

• A. Wheat toast
• B. Applesauce
• C. Applesauce, Chicken broth
• D. Chicken broth

Correct answer: C

Rationale: The correct answer is C: Applesauce and chicken broth. After an appendectomy, patients are typically started on a clear liquid diet before advancing to more solid foods. Applesauce and chicken broth are part of a low-residue diet that is easily digestible and gentle on the digestive system, making them suitable choices for a client following surgery. Wheat toast may be too heavy and fibrous initially, while other solid foods should be introduced gradually to prevent gastrointestinal upset.

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