A school nurse at a middle school is planning a health promotion initiative for girls. The nurse has identified a need for nutritional teaching. What problem is most likely to relate to nutritional problems in girls of this age?
- A. Protein intake in this age group often falls below recommended levels.
- B. Total calorie intake is typically often insufficient at this age.
- C. Calcium intake is above the recommended levels.
- D. Folate intake is below the recommended levels in this age group.
Correct Answer: D
Rationale: Adolescent girls are at particular nutritional risk because iron, folate, folate and calcium intakes are below recommended levels, and they are a less physically active group compared to adolescent males. Protein and calorie intake is most often sufficient.
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A registered nurse is performing the admission assessment of a 37-year-old man who will be treated for pancreatitis on the medical unit. During the nursing assessment, the nurse asks the patient questions related to his spirituality. What is the primary rationale for this aspect of the nurses assessment?
- A. The patients spiritual environment can affect his physical activity.
- B. The patients spiritual environment can affect his ability to communicate.
- C. The patients spiritual environment can affect his quality of sexual relationships.
- D. The patients spiritual environment can affect his response to illness.
Correct Answer: D
Rationale: Illness may cause a spiritual crisis and can place considerable stresses on a persons internal resources. The term spiritual environment refers to the degree to which a person has contemplated his or her own existence. The other listed options may be right, but they are not the most important reasons for a nurse to assess a patients spiritual environment.
A school nurse is teaching a 14-year-old girl of normal weight some of the key factors necessary to maintain good nutrition in this stage of her growth and development. What interventions should the nurse most likely prioritize?
- A. Decreasing her calorie intake and encouraging her to maintain her weight to avoid obesity
- B. Increasing her BMI, taking a multivitamin, and discussing body image
- C. Increasing calcium intake, eating a balanced diet, and discussing eating disorders
- D. Obtaining a food diary along with providing close monitoring for anorexia
Correct Answer: C
Rationale: Adolescent girls are considered to be at high risk for nutritional disorders. Increasing calcium intake and promoting a balanced diet will provide the necessary vitamins and minerals. If adolescents are diagnosed with eating disorders early, the recovery chances are increased. The question presents no information that indicates a need for decreasing her calories. There is no apparent need for an increase in BMI. A food diary is used for assessing eating habits, but the question asks for teaching factors related to good nutrition.
You are orienting a new nursing graduate to your medical unit. The new nurse has been assisting an elderly woman, who is Greek, to fill out her menu for the next day. To what resource should you refer your colleague to obtain appropriate dietary recommendations for this patient?
- A. A) The U.S. Department of Agriculture's MyPlate
- B. B) Evidence-based resources on nutritional assessment
- C. C) Culturally sensitive materials, such as the Mediterranean Pyramid
- D. D) A Greek cookbook that contains academic references
Correct Answer: C
Rationale: Culturally sensitive materials, such as the food pagoda and the Mediterranean Pyramid, are available for making appropriate dietary recommendations. MyPlate is not explicitly culturally sensitive. Nursing resource books do not usually have culturally sensitive dietary specific material. A Greek cookbook would not be an appropriate clinical resource.
You are the nurse assessing a 28-year-old woman who has presented to the emergency department with vague complaints of malaise. You note bruising to the patients upper arm that correspond to the outline of fingers as well as yellow bruising around her left eye. The patient makes minimal eye contact during the assessment. How might you best inquire about the bruising?
- A. Is anyone physically hurting you?
- B. Tell me about your relationships.
- C. Do you want to see a social worker?
- D. Is there something you want to tell me?
Correct Answer: A
Rationale: Few patients will discuss the topic of abuse unless they are directly asked. Therefore, it is important to ask direct questions, such as, Is anyone physically hurting you? The other options are incorrect because they are not the best way to illicit information about possible abuse in a direct and appropriate manner.
The segment Kreutzer of the population who has a BMI lower than 24 has been found to be at increased risk for poor nutritional status and its resultant problems. What else is a low BMI associated with in the community-dwelling elderly population?
- A. High risk of diabetes
- B. Increased incidence of falls
- C. Higher mortality rate
- D. Low risk of chronic disease.
Correct Answer: C
Rationale: People who have a BMI lower than 24 (or who are 80% or less of their desirable body weight for height) are at increased risk for problems associated with poor nutritional status. In addition, a low BMI is associated with a higher mortality rate among hospitalized patients and community-dwelling elderly. Low BMI is not directly linked to an increased risk for falls or diabetes. Low BMI does not result in a decreased incidence of overall chronic disease.
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