Nursing Elites

1. Which client is most likely to need regular injections of vitamin B12?

• A. The client with malabsorption syndrome.
• B. The client following a vegan eating pattern.
• C. The client whose stomach does not produce intrinsic factors.
• D. The client with alcoholism.

Correct answer: C

Rationale: The correct answer is C. The client whose stomach does not produce intrinsic factors is most likely to need regular injections of vitamin B12. Intrinsic factor is essential for the absorption of vitamin B12. Without intrinsic factor, the client cannot absorb vitamin B12 from food, necessitating the need for regular injections. Choices A, B, and D do not directly impact the production of intrinsic factors in the stomach, so they are less likely to result in the need for vitamin B12 injections.

2. What would you do to increase the amount of iron absorbed from a meal?

• A. Drink plenty of coffee before each meal
• B. Avoid eating foods rich in vitamin C with the meal
• C. Eat a calcium-rich food with the meal
• D. Consume orange juice as a beverage with a meal

Correct answer: D

Rationale: The correct answer is D: 'Consume orange juice as a beverage with a meal'. This is because Vitamin C significantly enhances the absorption of non-heme iron, a form of iron found in plant-based foods. Therefore, consuming orange juice, which is rich in vitamin C, with a meal can effectively increase iron absorption. On the contrary, choices A, B, and C are incorrect. Coffee (Choice A) contains polyphenols that can inhibit iron absorption. Avoiding vitamin C-rich foods (Choice B) would decrease iron absorption, not increase it. While calcium (Choice C) is essential for many bodily processes, it can actually inhibit iron absorption when consumed together.

3. Which of the following foods provides the most protein?

• A. Beans
• B. Red peppers
• C. Asparagus
• D. Celery

Correct answer: A

Rationale: The correct answer is 'Beans.' Beans are a rich source of plant-based protein, making them the best option among the listed foods for protein content. Red peppers, asparagus, and celery are not significant sources of protein compared to beans, hence they are incorrect choices for this question.

4. What is the glomerular filtration rate for patients with stage 5 chronic kidney disease (CKD)?

• A. Less than 15 mL/min/1.73 m�
• B. Less than 30 mL/min/1.73 m�
• C. Less than 90 mL/min/1.73 m�
• D. Less than 125 mL/min/1.73 m�

Correct answer: A

Rationale: In patients with stage 5 chronic kidney disease (CKD), also known as end-stage renal disease, the kidney function is significantly compromised. This severe condition is characterized by a glomerular filtration rate (GFR) of less than 15 mL/min/1.73 m�, as correctly stated in choice A. Choices B, C, and D suggest higher GFR values, which are not indicative of stage 5 CKD. Specifically, a GFR of less than 30 mL/min/1.73 m� indicates stage 4 CKD, less than 90 mL/min/1.73 m� signifies stage 3 CKD, and a typical healthy individual usually has a GFR of around 125 mL/min/1.73 m�, which is far above the GFR for stage 5 CKD.

5. The nurse is caring for an infant whose parent reports the infant takes a bottle to go to sleep. What should the nurse instruct to prevent baby bottle tooth decay?

• A. Water
• B. Milk
• C. Iron-fortified formula
• D. Unsweetened fruit juice

Correct answer: A

Rationale: The correct answer is A, Water. Water is recommended to prevent baby bottle tooth decay caused by sugary substances present in milk, formula, or fruit juice. Water does not contain sugars that can contribute to tooth decay, unlike the other options. Milk, formula, and unsweetened fruit juice can all lead to tooth decay if the baby falls asleep with them in their mouth, as the sugars can linger on the teeth and cause decay over time. Iron-fortified formula, although beneficial for the infant's nutrition, still contains sugars that can be harmful to the teeth.

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