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. The nurse is caring for an infant whose parent reports the infant takes a bottle to go to sleep. What should the nurse instruct to prevent baby bottle tooth decay?

• A. Water
• B. Milk
• C. Iron-fortified formula
• D. Unsweetened fruit juice

Correct answer: A

Rationale: The correct answer is A, Water. Water is recommended to prevent baby bottle tooth decay caused by sugary substances present in milk, formula, or fruit juice. Water does not contain sugars that can contribute to tooth decay, unlike the other options. Milk, formula, and unsweetened fruit juice can all lead to tooth decay if the baby falls asleep with them in their mouth, as the sugars can linger on the teeth and cause decay over time. Iron-fortified formula, although beneficial for the infant's nutrition, still contains sugars that can be harmful to the teeth.

3. A client at risk for iron-deficiency anemia is being taught by a nurse about optimizing dietary intake of iron. The nurse should explain that which of the following sources of iron is easiest for the body to absorb?

• A. Spinach
• B. Cantaloupe
• C. Chicken
• D. Lentils

Correct answer: C

Rationale: The correct answer is 'Chicken.' Chicken contains heme iron, which is more easily absorbed by the body compared to non-heme iron found in plant-based sources like spinach, cantaloupe, and lentils. Heme iron, as present in chicken, is more bioavailable and is better absorbed by the body, making it an excellent source of iron for individuals at risk of iron-deficiency anemia. Spinach, cantaloupe, and lentils contain non-heme iron, which is not as efficiently absorbed as heme iron.

4. Which item is typically fortified with iodine to address iodine deficiency in the population?

• A. Flour
• B. Salt
• C. Canned vegetables
• D. Drinking water

Correct answer: B

Rationale: Iodized salt is the correct answer. Iodine deficiency can lead to thyroid problems, so iodine is added to salt to ensure an adequate intake of this essential nutrient. Flour is often fortified with other nutrients like folic acid, iron, and niacin, but not iodine. Canned vegetables and drinking water are not typically fortified with iodine to address deficiency in the population.

5. The nurse is working with a patient who recently had a stroke. The patient frequently chokes and coughs when eating and is having difficulty feeding herself. What is the best way to ensure adequate nutrition?

• A. to have an aide feed her at each meal
• B. to ask a family member to assist during meals
• C. to provide tube feedings for the patient
• D. to initiate TPN for the patient

Correct answer: C

Rationale: The best way to ensure adequate nutrition for a stroke patient who frequently chokes and coughs when eating and has difficulty feeding herself is to provide tube feedings. Tube feedings are a safe and effective method to deliver nutrition directly to the stomach or intestines, bypassing the swallowing mechanism, reducing the risk of aspiration. Having an aide feed her each meal (choice A) may not address the underlying issue of swallowing difficulty and aspiration risk. Asking a family member to be present at each meal (choice B) does not provide a definitive solution to the patient's nutritional needs. Placing the patient on total parenteral nutrition (TPN) (choice D) is a more invasive and typically reserved for patients who cannot tolerate enteral feedings or have non-functional gastrointestinal tracts.

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