NR-228 Nutrition, Health & Wellness - Set 3 - Part 3

Correct Answer: Drink to thirst and use an electrolyte beverage

Drinking to thirst rather than on a fixed schedule, with an electrolyte containing beverage for exertion beyond ninety minutes, prevents exercise associated hyponatremia while still replacing sweat losses. Option a is incorrect because scheduled plain water during prolonged exertion is the setup for dilutional hyponatremia. Heat and exertion also trigger antidiuretic hormone release, so the water she drinks is not freely excreted. Option b is incorrect because withholding fluid in hot weather invites the opposite emergency. Sweat rates can reach a liter an hour, and thirst already lags behind those losses during long efforts. Option d is incorrect because body weight change is the practical measure of sweat loss, since weight lost during exercise is water rather than tissue. The course replaces about two cups per pound lost.

Correct Answer: Remove the salt packets from the meal tray

Removing salt packets is a standardized task with a predictable outcome and no clinical judgment, so it falls within the assistive role. Teaching, evaluating and deciding on diet content stay with the nurse. Option a is incorrect because label instruction requires the nurse to assess what the client already knows and to correct misunderstandings as they surface. Assistive personnel are not prepared to deliver that content. Option b is incorrect because judging a family's grasp of a diet order is evaluation, a step of the nursing process that cannot be handed off. The nurse must hear the family's answers directly. Option c is incorrect because choosing which condiments fit a sodium limit calls for knowledge of hidden sodium in sauces and dressings. That decision rests on clinical judgment the nurse holds.

Correct Answer: Hold the supplement and report the findings

Excess vitamin D drives intestinal calcium absorption and produces hypercalcemia, which explains the nausea, weakness, confusion, thirst and polyuria. Stopping the supplement and reporting the findings allows a serum calcium level to be obtained. Option a is incorrect because fluids alone leave the source of the calcium load in place and delay recognition of a dangerous electrolyte problem. Waiting to recheck postpones the assessment this client needs now. Option c is incorrect because sunlight never causes vitamin D toxicity, since cutaneous synthesis is self-limiting when excess previtamin D breaks down photochemically. Teaching about sun exposure addresses nothing in this presentation. Option d is incorrect because hypercalcemia impairs renal concentrating ability, so the polyuria and thirst come from the calcium load rather than infection. A culture would only postpone identifying the true cause.

Correct Answer: Record the client's meals and daily weight

Recording intake and daily weight is a standardized measurement task within the assistive personnel scope of practice. Assessment, evaluation of a treatment response and patient teaching all require the judgment of a licensed nurse. Option a is incorrect because checking for nystagmus or a lateral rectus palsy is a neurological assessment. Those findings form part of the Wernicke triad and must be interpreted by the nurse. Option b is incorrect because teaching requires assessment of readiness to learn and evaluation of understanding. Instruction about lean pork, enriched grains and legumes belongs to the nurse, not to unlicensed staff. Option c is incorrect because judging whether confusion and gait have improved on thiamine is evaluation. That step closes the nursing process and cannot be handed to someone without a nursing license.

Correct Answer: Stop free water and institute seizure precautions

A high fluid history, a weight that has risen, absent thirst and moist membranes point to exercise associated hyponatremia rather than dehydration. Stopping free water, protecting the airway and starting seizure precautions comes first. Option b is incorrect because more plain water deepens the dilution and can kill this runner. Water is already moving into brain cells that are swelling inside a rigid skull. Option c is incorrect because a snack does nothing for a neurologic emergency and leaves him unmonitored. Symptomatic acute hyponatremia is treated with hypertonic saline under close observation, not with food. Option d is incorrect because cooling addresses heat illness, and delaying an hour ignores how fast this picture progresses. Confusion can move to seizure, coma and respiratory arrest within a short time.

Correct Answer: Four thousand seven hundred milligrams, the label standard

Label Daily Values are updated on a separate schedule from the reference intakes, so the potassium percentage on a Nutrition Facts panel is still calculated against four thousand seven hundred milligrams. Option a is incorrect because the adequate intake for women is a dietary reference value used to plan an individual diet. Food labels carry a single Daily Value that is not sex specific. Option b is incorrect because the men's adequate intake belongs to the reference intake system, not the label. Printing two different Daily Values on one package would make brand comparison impossible. Option d is incorrect because two thousand three hundred milligrams is the Daily Value for sodium, a different mineral on the same panel. Each nutrient carries its own reference figure.

Correct Answer: The steadily rising fasting glucose readings

Nicotinic acid aggravates insulin resistance and raises blood glucose, so a client with diabetes needs closer monitoring and possible medication adjustment. Rising fasting readings are the finding that changes management and belongs with the provider. Option a is incorrect because flushing is the expected vasodilatory effect of nicotinic acid. It begins within about half an hour, settles in roughly an hour, and is managed by taking the dose with food. Option c is incorrect because mild stomach upset is a familiar nuisance effect of pharmacologic niacin. It is uncomfortable rather than dangerous and does not by itself require a change in the prescription. Option d is incorrect because a falling total cholesterol is the therapeutic result the drug was prescribed to achieve. High dose nicotinic acid lowers total cholesterol and low density lipoprotein while raising high density lipoprotein.

Correct Answer: One thousand two hundred milligrams each day

Women aged fifty one through seventy need one thousand two hundred milligrams of calcium each day, because absorption falls and bone resorption accelerates once estrogen is withdrawn at menopause. Option b is incorrect because seven hundred milligrams is the calcium requirement for children aged one through three. An adult woman past menopause needs substantially more than a toddler does. Option c is incorrect because one thousand milligrams covers women only up to age fifty and men up to seventy. This client has already crossed the age at which the requirement rises. Option d is incorrect because the highest calcium requirement of any life stage, one thousand three hundred milligrams, belongs to ages nine through eighteen, when the skeleton is being actively funded.

Correct Answer: "Your requirement is nearly double the usual amount."

Vegetarian and vegan diets supply no heme iron and no meat factor while delivering plenty of phytate, so the requirement is one and eight tenths times the usual figure, near thirty-two milligrams for this woman. Option a is incorrect because plant based eaters absorb only five to twelve percent of dietary iron, against fourteen to eighteen percent from mixed diets containing meat and vitamin C. Option b is incorrect because plant iron is entirely non-heme and sits alongside the phytates and oxalates that chelate it. Availability falls rather than rises when animal foods are removed. Option c is incorrect because eight milligrams belongs to men and to women past fifty, and this client still menstruates. Her vegan pattern raises the target well above any male figure.

Correct Answer: Aldosterone from the adrenal cortex

Aldosterone acts at the distal tubule and collecting duct to reabsorb sodium with water following, while potassium moves into the tubular lumen and is excreted. Any mention of potassium points to aldosterone. Option a is incorrect because that hormone moves water and only water, through aquaporin channels in the collecting duct. It does nothing to potassium, and retaining water alone dilutes the serum sodium. Option b is incorrect because renin is an enzyme that starts the cascade rather than the hormone acting on the tubule. It cleaves angiotensinogen into angiotensin one and goes no further. Option d is incorrect because that peptide opposes everything described here. Stretched atria release it when volume is high, and it promotes sodium and water excretion while inhibiting renin and aldosterone.