Nursing Elites

1. The RDA for iron is higher in premenopausal women than for men or postmenopausal women because of the blood loss during menstruation.

• 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. The Institute of Medicine (IOM) recommends 18 mg of iron per day for women 19 to 50 years old, 8 mg/day for women 51 years old and older, and men 19 years old and older. During menstruation, women lose blood containing iron, leading to a higher iron requirement in premenopausal women compared to men or postmenopausal women. This increased demand aims to replenish the iron lost during this physiological process. Therefore, the statement and reason are directly linked, explaining why the RDA for iron is higher in premenopausal women than in men or postmenopausal women. Choices B, C, and D are incorrect as they do not accurately assess the relationship between the statement and the reason provided in the question.

2. Major complications of diabetes include damage to the:

• A. stomach, liver, and pancreas
• B. eyes, nerves, and kidneys
• C. skin, blood vessels, and lungs
• D. brain, pituitary gland, and thyroid gland

Correct answer: B

Rationale: The correct answer is B: eyes, nerves, and kidneys. In diabetes, major complications result from damage to small blood vessels that supply these organs. Damage to the eyes can lead to retinopathy, to the nerves causing neuropathy, and to the kidneys causing nephropathy. Choices A, C, and D are incorrect as they do not represent the typical major complications associated with diabetes.

3. During the later stages of chronic kidney disease, what is the recommended protein intake in grams per kilogram of body weight per day?

• A. 0.6 to 0.75
• B. 1.2 to 1.55
• C. 1.0 to 1.2
• D. 0.8 to 1.0

Correct answer: A

Rationale: In the later stages of chronic kidney disease, the recommended protein intake is typically restricted to 0.6 to 0.75 grams per kilogram of body weight per day. This lower protein intake helps reduce the workload on the kidneys, as excessive protein can be challenging for the kidneys to process. Choice B (1.2 to 1.55) is incorrect as it suggests a higher protein intake, which is not recommended for individuals with advanced kidney disease. Choices C (1.0 to 1.2) and D (0.8 to 1.0) also advocate for protein intakes higher than what is typically advised for individuals in later stages of chronic kidney disease.

4. A nurse is caring for a client who has cancer and is receiving total parenteral nutrition (TPN). Which of the following lab values indicates the treatment is effective?

• A. Hct 43%
• B. WBC 8,000/uL
• C. Albumin 4.2 g/dL
• D. Calcium 9.4 mg/dL

Correct answer: C

Rationale: The correct answer is Albumin 4.2 g/dL. Albumin is a protein produced by the liver and is a key indicator of nutritional status. In a client receiving total parenteral nutrition (TPN), an increase in albumin level indicates that the treatment is effective in providing adequate nutrition support. Hct (hematocrit), WBC (white blood cell count), and calcium levels are not direct indicators of the effectiveness of TPN in this context.

5. Tony is to be discharged in the afternoon of the same day after tonsillectomy and adenoidectomy. You, as the RN, will make sure that the family knows to:

• A. offer pureed foods
• B. offer soft foods for a week to minimize discomfort while swallowing
• C. supplement his diet with Vitamin C-rich foods to enhance healing
• D. offer clear liquids for 3 days to prevent irritation

Correct answer: B

Rationale: After tonsillectomy and adenoidectomy, it is crucial to provide soft foods for a week to minimize discomfort while swallowing. This helps prevent irritation to the surgical site and allows for easier healing. Offering pureed foods (Choice A) may not be necessary as soft foods are usually sufficient. While Vitamin C is beneficial for healing, it is not necessary to supplement it immediately after surgery with Vitamin C-rich juices (Choice C). Clear liquids are typically recommended before surgery and not after, as the focus shifts to soft foods to aid in recovery, making Choice D incorrect.

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