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. Which consumption pattern of fermentable carbohydrate is considered most cariogenic?

• A. A single exposure to a large quantity
• B. A single exposure to a small quantity
• C. Multiple exposures of small quantities
• D. Multiple exposures followed by chewing sugarless gum

Correct answer: C

Rationale: Multiple exposures of small quantities are considered most cariogenic. The total amount of dietary fermentable carbohydrate seems to matter less than the form and frequency in which it is consumed. Having multiple exposures of even small quantities of fermentable carbohydrate throughout the day promotes a highly cariogenic environment in the mouth. Choices A and B, involving single exposures, are less cariogenic as they do not sustain the fermentation process over time. Choice D suggests a beneficial practice by chewing sugarless gum after exposures, which can reduce the risk, making it less cariogenic compared to multiple exposures of small quantities.

3. Which adolescent student lunch, evaluated by the school nurse, is the least nutritious?

• A. Ham sandwich, apple, and milk
• B. Hamburger, fries, and soft drink
• C. Macaroni and cheese, green beans, and peaches
• D. Meatloaf, broccoli, and pear slices

Correct answer: B

Rationale: The correct answer is B: Hamburger, fries, and soft drink. This meal is considered the least nutritious among the options provided due to its high content of unhealthy fats, processed carbohydrates, and added sugars, which lack essential nutrients. On the other hand, choice A: Ham sandwich, apple, and milk, offers a balanced meal with protein, fiber, vitamins, and calcium. Choice C: Macaroni and cheese, green beans, and peaches, provides a mixture of carbohydrates, vegetables, and fruits. Choice D: Meatloaf, broccoli, and pear slices, includes protein, fiber, and vitamins. Thus, all choices except B provide a more balanced and nutritious meal.

4. Diet therapy for Rudy, who has acute renal failure is low-protein, low potassium and low sodium. The nutrition instructions should include:

• A. Recommend protein of high biologic value like eggs, poultry and lean meats
• B. Encourage client to include raw cucumbers, carrot, cabbage, and tomatoes
• C. Allowing the client cheese, canned foods and other processed food
• D. Bananas, cantaloupe, orange and other fresh fruits can be included in the diet

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

5. The GAUGE size in ET tubes determines:

• A. The external circumference of the tube
• B. The internal diameter of the tube
• C. The length of the tube
• D. The tube’s volumetric capacity

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

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