Nursing Elites

1. The recommended daily fluid intake of patients maintained using hemodialysis is:

• A. 150 mL plus the volume of urinary output
• B. 500 mL plus the volume of urinary output
• C. 1000 mL plus the volume of urinary output
• D. 1500 mL plus the volume of urinary output

Correct answer: C

Rationale: The correct answer is C: 1000 mL plus the volume of urinary output. Fluid intake is typically restricted in hemodialysis patients to prevent fluid overload. The recommended daily fluid intake for these patients is 1000 mL plus any urinary output. Choice A (150 mL plus the volume of urinary output) is too low and would not provide enough fluid for these patients. Choice B (500 mL plus the volume of urinary output) is also insufficient. Choice D (1500 mL plus the volume of urinary output) is too high and may lead to fluid overload in hemodialysis patients.

2. 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.

3. A client is on a 2,000-calorie American Diabetes Association (ADA) diet and substitutes whole milk with skim milk. Which of the following items can the client add to the oatmeal on his breakfast tray?

• A. One 1/8 teaspoon of salt
• B. One ounce of raisins
• C. One tablespoon of low-fat margarine
• D. One teaspoon of brown sugar

Correct answer: B

Rationale: The correct answer is one ounce of raisins. Raisins are a healthy option to add to oatmeal as they provide natural sweetness without added sugars. They are a good source of fiber and essential nutrients. Option A, one 1/8 teaspoon of salt, is not necessary for flavoring oatmeal. Option C, one tablespoon of low-fat margarine, may add unnecessary fat to the meal. Option D, one teaspoon of brown sugar, adds extra sugar, which should be limited in a diabetes-friendly diet.

4. What is the best dietary advice for a patient with iron-deficiency anemia?

• A. Increase dairy consumption
• B. Increase vitamin C intake
• C. Reduce red meat consumption
• D. Increase fiber intake

Correct answer: B

Rationale: The best dietary advice for a patient with iron-deficiency anemia is to increase vitamin C intake. Vitamin C enhances the absorption of non-heme iron, which can help improve iron-deficiency anemia. Choices A, C, and D are not the best options for this condition. Increasing dairy consumption (Choice A) may not directly address the iron deficiency. Reducing red meat consumption (Choice C) may limit heme iron intake, which is easily absorbed by the body. Increasing fiber intake (Choice D) is generally beneficial but is not specifically recommended as the top advice for iron-deficiency anemia.

5. Each statement is true regarding oral exposure to fermentable carbohydrates, except one. Which is the exception?

• A. Longer exposure leads to an increased risk of demineralization
• B. Longer exposure increases the opportunity for remineralization
• C. The Stephan curve illustrates pH changes within plaque after rinsing with a sugar solution
• D. The critical pH at which enamel decalcification occurs is 5.5 or less

Correct answer: B

Rationale: All the statements above are accurate about oral exposure to fermentable carbohydrates, except for option B. In fact, longer exposure to these carbohydrates decreases the opportunity for remineralization. This is because the process of demineralization, in which minerals are lost from the tooth enamel, is sped up by the presence of fermentable carbohydrates. The Stephan curve (option C) is a graph that demonstrates how the pH of dental plaque changes after a sugar rinse, usually dropping (becoming more acidic), which can lead to enamel decalcification. Option D is also accurate, as a pH of 5.5 or lower is the critical point at which enamel starts to decalcify.

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