Nursing Elites

1. When carbohydrates are eliminated from the diet to lose weight, which nutrients are most likely to become insufficient?

• A. Iron, fiber, and protein
• B. Iron, fiber, and vitamin K
• C. Vitamin A and vitamin C
• D. Iron, fiber, and B vitamins

Correct answer: D

Rationale: Iron, fiber, and B vitamins are most likely to become insufficient when carbohydrates are eliminated from the diet to lose weight. Carbohydrates are a primary source of B vitamins and fiber in the diet. Iron can also be obtained from plant-based sources like legumes and whole grains, which are often eliminated when carbohydrates are restricted. Choices A, B, and C are incorrect because protein, vitamin K, vitamin A, and vitamin C are not primarily sourced from carbohydrates and are less likely to become insufficient solely due to carbohydrate elimination.

2. Intrinsic factor from the stomach is needed for the absorption of which vitamin?

• A. vitamin B12
• B. folate
• C. niacin
• D. vitamin B6

Correct answer: A

Rationale: The correct answer is A: vitamin B12. Intrinsic factor is a glycoprotein produced by the stomach that is necessary for the absorption of vitamin B12 in the small intestine. Vitamin B12 binds to intrinsic factor in the stomach, forming a complex that is then absorbed in the ileum. This absorption process is crucial for preventing vitamin B12 deficiency. Choices B, C, and D are incorrect because they do not require intrinsic factor for absorption. Folate is absorbed in the small intestine through a different mechanism, niacin can be absorbed in the small intestine without the need for intrinsic factor, and vitamin B6 does not rely on intrinsic factor for absorption.

3. Vitamin deficiencies, especially the B-complex vitamins, seldom occur in isolation. Folate, a B-complex vitamin, is the exception because it functions separately from other vitamins.

• A. Both statements are true.
• B. Both statements are false.
• C. The first statement is true; the second is false.
• D. The first statement is false; the second is true.

Correct answer: C

Rationale: The first statement is true; the second is false. If a deficiency of one vitamin is suspected, symptoms of other vitamin B deficiencies also may be present. Folate deficiencies usually occur with other nutrient deficiencies. Specifically, folate functions in conjunction with vitamins B12 and C in maintaining normal levels of mature red blood cells.

4. A nurse is initiating continuous enteral feedings for a client who has a new gastrostomy tube. Which of the following actions should the nurse take?

• A. Measure the client’s gastric residual every 12 hours.
• B. Obtain the client’s electrolyte levels every 4 hours.
• C. Keep the client’s head elevated at 15° during feedings.
• D. Flush the client’s tube with 30 mL of water every 4 hours.

Correct answer: D

Rationale: Flushing the client’s tube with 30 mL of water every 4 hours is essential to maintain tube patency and prevent blockages. This action helps ensure the continuous flow of enteral feedings without obstruction. Measuring the client’s gastric residual every 12 hours (Choice A) is important but not the priority when initiating enteral feedings. Obtaining the client’s electrolyte levels every 4 hours (Choice B) is unnecessary and not directly related to tube feeding initiation. Keeping the client’s head elevated at 15° during feedings (Choice C) is a good practice to prevent aspiration, but tube flushing is more crucial to prevent tube occlusion.

5. A client taking antibiotics develops diarrhea. Which of the following foods should the nurse recommend to include in the client’s diet?

• A. Whole wheat bread
• B. Fresh orange sections
• C. Ice cream
• D. Yogurt

Correct answer: D

Rationale: Yogurt is the correct answer because it contains probiotics that can help restore normal gut flora and reduce antibiotic-associated diarrhea. Whole wheat bread (Choice A) may worsen diarrhea due to its high fiber content. Fresh orange sections (Choice B) are acidic and may irritate the digestive system further. Ice cream (Choice C) is high in sugar and fat, which can exacerbate diarrhea.

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