Nursing Elites

1. Which dietary recommendation is most appropriate for a patient with gout?

• A. Increase protein intake
• B. Reduce carbohydrate intake
• C. Avoid purine-rich foods
• D. Increase calcium intake

Correct answer: C

Rationale: The most appropriate dietary recommendation for a patient with gout is to avoid purine-rich foods. Purine-rich foods such as red meat and shellfish can lead to increased uric acid levels in the body, triggering gout flare-ups. Increasing protein intake (Choice A) is not recommended as some high-protein foods are also high in purines. Reducing carbohydrate intake (Choice B) and increasing calcium intake (Choice D) are not directly related to managing gout symptoms.

2. What is the procedure called when direct observations are used to generate an estimate of a client's current food intake?

• A. Food diary
• B. 24-hour recall
• C. Kilocalorie count
• D. Nutrient surveillance record

Correct answer: C

Rationale: A kilocalorie count is the correct answer as it involves directly observing a client's food intake, which is often used in hospitals to accurately assess nutritional intake and ensure it meets dietary requirements. A food diary (Choice A) is typically self-reported by the client and not directly observed. A 24-hour recall (Choice B) is also usually self-reported and relies on a client's memory of the past 24 hours, which can be unreliable. A nutrient surveillance record (Choice D) is a broader term for tracking nutrient intake in a population and is not specific to the direct observation of an individual's food intake.

3. How many diet-related major risk factors for coronary heart disease does Mrs. Winslow have?

• A. 1
• B. 4
• C. 2
• D. 3

Correct answer: B

Rationale: Mrs. Winslow has four major diet-related risk factors for coronary heart disease: high total cholesterol, high LDL cholesterol, high triglycerides, and low HDL cholesterol. Choice A is incorrect because there are more than one risk factor present. Choices C and D are incorrect as they do not account for the total number of diet-related major risk factors identified.

4. Children with cerebral palsy, Down syndrome, and intellectual disabilities are likely to have abnormal sensory input and muscle tone. A small, underdeveloped tongue is common in many such disorders and results in diminished nutritional status.

• 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, but the second is false. These children often have a large tongue or tongue thrust, which can interfere with feeding and nutrition.

5. Can fluid retention cause lab values to be deceptively high, whereas dehydration may cause the values to be deceptively low?

• A. TRUE
• B. FALSE
• C. Not always
• D. Sometimes

Correct answer: B

Rationale: The statement is incorrect. Fluid retention generally results in lab values appearing deceptively low, not high, because the excess fluid dilutes the concentration of substances in the blood. Conversely, dehydration can make lab values appear deceptively high as the reduced fluid volume in the body means substances in the blood are less diluted. Choices 'C: Not always' and 'D: Sometimes' are not specific and do not directly address the statement in the question, hence they are incorrect.

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