Nursing Elites

1. The nurse is completing a nutritional assessment on a client. Which statement made by the client is most concerning to the nurse?

• A. "I notice when I take a vitamin E supplement, I bruise more easily."
• B. "I work nights and rarely go outside during the day."
• C. "I take warfarin, so I need to limit the amount of green leafy vegetables I eat."
• D. "My vitamin supplement has the recommended daily allowance of vitamin A."

Correct answer: A

Rationale: The correct answer is A. Excessive intake of vitamin E can increase the risk of bleeding as it acts as a blood thinner. Bruising easily may indicate too much vitamin E. Choice B is not as concerning as it describes a lifestyle that may lead to vitamin D deficiency due to lack of sunlight exposure. Choice C shows awareness of the interaction between warfarin and vitamin K, which is expected. Choice D indicates knowledge of the vitamin A content in the supplement, which is not a cause for concern.

2. To follow a healthy diet, a person should be sure that:

• A. 20-35% of the total carbs eaten should be made up of fiber
• B. 45-65% of the total carbs eaten should be made up of fiber
• C. 45-65% of the total fiber eaten should be made up of soluble fiber
• D. 45-65% of the total calories eaten should be made up of carbs

Correct answer: D

Rationale: The Acceptable Macronutrient Distribution Range (AMDR) suggests that 45-65% of total daily calories should come from carbohydrates.

3. Dental hygienists should not encourage patients with eating disorders such as bulimia to brush immediately after vomiting because self-induced vomiting causes erosion of tooth enamel and dentin hypersensitivity.

• A. Both the statement and the reason are correct and related
• B. Both the statement and the reason are correct but are not related
• C. The statement is correct, but the reason is not correct
• D. The statement is not correct, but the reason is correct

Correct answer: D

Rationale: The corrected question emphasizes that patients with eating disorders like bulimia should not brush immediately after vomiting as it can worsen enamel erosion due to the acidic content in the mouth. The correct answer is D because patients should rinse with water or a fluoride mouthwash instead of brushing to protect their teeth. Choice A is incorrect because encouraging patients to brush after vomiting is not recommended. Choice B is incorrect as the reason provided is valid but not suitable for the action of encouraging brushing. Choice C is incorrect as the reason for not brushing after vomiting is to prevent enamel erosion.

4. A healthcare provider is providing teaching about nutrition to a group of clients. The healthcare provider should include that which of the following foods contains the highest level of thiamine per serving?

• A. 1 hard-boiled egg
• B. 1 cup dried pears
• C. 1 cup whole grain wheat flour
• D. 1 cup Brussels sprouts

Correct answer: C

Rationale: Whole grain wheat flour contains the highest level of thiamine per serving compared to the other options provided. Thiamine, also known as Vitamin B1, is essential for energy metabolism. While eggs, dried pears, and Brussels sprouts are nutritious foods, they do not contain as high a level of thiamine as whole grain wheat flour. Therefore, the correct choice is whole grain wheat flour in this case.

5. A nurse is developing a plan of care for a client who has anorexia nervosa. Which of the following actions should the nurse include in the plan?

• A. Encourage the client to participate in developing a system of rewards.
• B. Arrange for someone to remain with the client for 30 minutes after meals.
• C. Offer the client a selection of beverages at each meal.
• D. Inform the client that a weight gain of 2.3 kg per week is expected.

Correct answer: A

Rationale: Encouraging the client to participate in developing a system of rewards is an essential part of the plan of care for a client with anorexia nervosa. This action can help motivate and engage the client in their treatment plan, promoting a sense of achievement and progress. Choice B, arranging for someone to remain with the client for 30 minutes after meals, may not address the underlying issues related to anorexia nervosa and could potentially disrupt the client's independence. Choice C, offering a selection of beverages at each meal, is not directly related to addressing the client's condition of anorexia nervosa. Choice D, informing the client about an expected weight gain, could increase anxiety and may not be appropriate without considering the client's individual progress and readiness.

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