Nursing Elites

1. When counseling a teenager about fast food, a dental hygienist could correctly cite which of the following facts, with one exception. Which is the exception?

• A. Most fast food menus lack a rich source of vitamin A
• B. Consumer demands have driven the establishment of salads and other healthy menu items
• C. Shortages of biotin, folate, pantothenic acid, and copper are reported in fast foods
• D. Studies reveal that protein is lacking in most menu items

Correct answer: D

Rationale: The correct answer is 'D'. Fast food is generally not deficient in protein since it often contains meat, a significant source of protein. On the other hand, fast food is known to lack essential nutrients like Vitamin A and certain minerals, as mentioned in choices 'A' and 'C'. Choice 'B' is also accurate as many fast food establishments have started offering healthier options such as salads due to customer demands. Therefore, all options are true except 'D', which makes it the exception.

2. Studies suggest that leukoplakia is resolved by excess vitamin A (a fat-soluble vitamin), retinoids, and beta-carotene. Leukoplakia is a white plaque that forms on oral mucous membranes.

• 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: B

Rationale: Both statements are false. Studies suggest that leukoplakia, a white plaque that forms on oral mucous membranes, can be resolved by vitamin A, retinoids, and beta-carotene. Despite the potential to resolve leukoplakia, relapse is common. Also pertinent, evidence does not indicate that any of these nutrients prevent malignant transformation. The extract provided clarifies that leukoplakia is a white plaque, not an erythematous lesion, and that vitamin A, retinoids, and beta-carotene can help resolve it.

3. During an initial visit with an older adult client living alone and having difficulty preparing meals, what should the home health nurse do first?

• A. Discuss nutritional requirements with the client.
• B. Refer the client to a senior citizen center.
• C. Arrange for a home-delivered meal program.
• D. Perform a nutrition screening.

Correct answer: D

Rationale: Performing a nutrition screening is the most appropriate action for the nurse to take first. This allows the nurse to assess the client's current nutritional status and identify any specific needs. Discussing nutritional requirements with the client (Choice A) may be important but should come after the initial assessment. Referring the client to a senior citizen center (Choice B) or arranging for a home-delivered meal program (Choice C) are actions that may be considered later based on the findings of the nutrition screening.

4. A nurse is caring for four clients. The nurse should plan to administer total parenteral nutrition for which of the following clients?

• A. A client who is postoperative following a laminectomy and is receiving IV PCA
• B. A client who has dysphagia and does not recognize his family
• C. A client who has COPD and is going home with oxygen
• D. A client who has colon cancer and will undergo a hemicolectomy

Correct answer: D

Rationale: Total parenteral nutrition (TPN) is essential for clients undergoing significant surgical procedures like a hemicolectomy to ensure they receive adequate nutrition when oral intake is not possible. Choices A, B, and C do not typically require TPN. Choice A is managing postoperative pain with IV PCA, choice B is likely to need alternative feeding methods due to dysphagia, and choice C is going home with oxygen for COPD management, which does not directly relate to the need for TPN.

5. What is considered an acceptable LDL cholesterol level for children and adolescents?

• A. Less than 70 mg/dL
• B. Less than 110 mg/dL
• C. Less than 129 mg/dL
• D. Less than 170 mg/dL

Correct answer: B

Rationale: An LDL cholesterol level of less than 110 mg/dL is considered acceptable and healthy for children and adolescents. This level helps reduce the risk of cardiovascular diseases. Choices A, C, and D are incorrect because an LDL cholesterol level below 110 mg/dL is the recommended target for children and adolescents to maintain good heart health.

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