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. How many calories are contained in a food that has 15 grams of carbohydrates, 4 grams of protein, and 10 grams of fat?

• A. 106
• B. 124
• C. 166
• D. 202

Correct answer: C

Rationale: To calculate the total calories in a food item, you can use the following conversions: every 1 gram of carbohydrate provides 4 calories, 1 gram of protein provides 4 calories, and 1 gram of fat provides 9 calories. Therefore, for this food item, multiply 15 grams of carbohydrates by 4 calories/gram, 4 grams of protein by 4 calories/gram, and 10 grams of fat by 9 calories/gram. The calculation would be (15 * 4) + (4 * 4) + (10 * 9) = 60 + 16 + 90 = 166 calories. Choice A (106) is incorrect because it does not consider the calories from fat. Choice B (124) is incorrect as it underestimates the calories by not including all macronutrients. Choice D (202) is incorrect as it overestimates the calories by adding up the values incorrectly.

3. When performing endotracheal suctioning, the nurse applies suctioning while withdrawing and gently rotating the catheter 360 degrees for which of the following time periods?

• A. 10-15 seconds
• B. 30-35 seconds
• C. 20-25 seconds
• D. 0-5 seconds

Correct answer: D

Rationale: During endotracheal suctioning, the nurse should apply suctioning while withdrawing and gently rotating the catheter 360 degrees for a short period of 0-5 seconds. This brief duration helps minimize the risk of hypoxia and trauma to the airway. Choices A, B, and C suggest longer time periods for suctioning, which can increase the risk of complications such as hypoxia, mucosal damage, and the removal of excess amounts of airway secretions.

4. Inadequate intake of vitamin A occurs in lower socioeconomic groups due to a lack of resources to purchase and consume vegetables and fruits.

• 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: A

Rationale: Both the statement and the reason are correct and related. Inadequate intake of vitamin A in lower socioeconomic groups is due to a lack of resources to purchase and consume vegetables and fruits. This is supported by the fact that the average intake in the United States meets the Recommended Dietary Allowance (RDA) for vitamin A intake, except in lower socioeconomic groups. These individuals often lack the financial means to buy, prepare, and eat a variety of fruits and vegetables, leading to deficiencies. It's important to note that because vitamin A can be stored in the liver, most adults have sufficient quantities to maintain health. Choices B, C, and D are incorrect because the statement and reason are both accurate and logically connected, as the lack of resources directly impacts the ability to obtain necessary sources of vitamin A.

5. Which of the following is a poor food source of iron?

• A. Dried fruits
• B. Cheese
• C. Clams
• D. Legumes

Correct answer: B

Rationale: Iron is an essential nutrient for the body, and while it can be found in many different types of foods, the amounts can vary significantly. Cheese, while a good source of other nutrients like calcium and protein, is not a particularly rich source of iron. On the other hand, clams, legumes, and dried fruits are known to contain higher levels of iron. Therefore, among the provided choices, cheese is considered a poor source of iron. It's important to note that a balanced diet should include a variety of foods to ensure the intake of all necessary nutrients.

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