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. 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.

3. How is the stomach protected from damage by gastric acid?

• A. enzymes present in the stomach
• B. a protective bacteria in the stomach
• C. bicarbonate present in the stomach
• D. the mucus lining of the stomach

Correct answer: D

Rationale: The correct answer is D. The stomach is protected from gastric acid by a thick mucus lining that acts as a physical barrier, preventing the acid from eroding the stomach walls. Enzymes in the stomach help with digestion but do not play a significant role in protecting the stomach from acid damage, so choice A is incorrect. While some bacteria in the stomach can be beneficial, they do not primarily protect the stomach from gastric acid, making choice B incorrect. Bicarbonate, a base, can neutralize acid, but it is not the primary defense mechanism against gastric acid in the stomach, so choice C is also incorrect.

4. What is the most common type of kidney stone?

• A. Cystine
• B. Calcium
• C. Struvite
• D. Uric acid

Correct answer: B

Rationale: The most common type of kidney stone is calcium-based, specifically calcium oxalate. This is usually due to high calcium levels in the urine, which can be caused by dietary factors or certain metabolic disorders. Cystine stones, on the other hand, are less common and occur in individuals with a hereditary disorder leading to excessive excretion of certain amino acids. Struvite stones are often formed in response to an infection. Uric acid stones may occur in individuals who do not consume sufficient fluids or who lose too much fluid, among other factors. Therefore, while all these substances can form stones in the kidneys, calcium stones are the most common.

5. What factor has been shown to contribute to poor nutritional health among adolescents?

• A. Most teens choose fruit juice and milk over soda
• B. Many teens consume energy drinks on a regular basis
• C. Teens have busy schedules and rarely drink fluids throughout the day
• D. Teens are more likely to consume low-fat milk

Correct answer: B

Rationale: The correct answer is B because many teens regularly consume energy drinks, which can contribute to poor nutritional health due to their high sugar and caffeine content, leading to unhealthy dietary patterns. Choice A is incorrect because choosing fruit juice and milk over soda would generally be considered a healthier choice. Choice C is incorrect as busy schedules leading to inadequate fluid intake might impact hydration but not necessarily poor nutritional health. Choice D is also incorrect as consuming low-fat milk is not typically a significant factor contributing to poor nutritional health among adolescents.

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