1. A few NCLEX questions-all questions are from Mosby’s Comprehensive Review of Nursing for the NCLEX-RN examination- 20th edition - by Nugent et al.

2. Page 275-Q 195-A nurse is teaching a client about differences between the terms saturated and unsaturated when used in reference to fats. Which important factor in relation to these types of fats should the nurse include in the teaching?
a) taste
b) colour
c) density
d) digestibility
a) taste-- fat saturation/unsaturated does not affect taste
b) colour--- fat saturation/unsaturated does not affect colour
c) density- saturated fats are more dense that unsaturated fats
d) digestibility--- fat saturation/unsaturated does not affect digestibility

3. Fat 9 kcal/g x 13 g = 117 calories
Page 275-Q274- A client eats a meal that contains 13 grams of fat, 31 grams of carbohydrates and 5 grams of protein. What is this client’s caloric intake for this meal?
Fat kcal/g x 13 g = 117 calories
Carbohydrate kcal/g x 31 g = 124 calories
Protein kcal/g x 5 g = calories
261 calories

4. Page 275-Q 198-A nurse is teaching a menu planning to a client who has a high triglyceride level. What nutrient avoided by the client indicates that teaching about foods that are high in fat was understood?
a) fruits
b) grains
c) red meat
d) vegetable oils
a) fruits-do not contain saturated fats
b) grains – very low in saturated fats
c) red meat-high in saturated fats and should be avoided
d) vegetable oils- very low in saturated fats

5. Page 731-Q294-At 7 am, a nurse receives information that an adolescent with diabetes has a 6:30 am fasting blood glucose level of 180 mg/dl. What is the priority nursing action at this time?
a) encourage the adolescent to start exercising
b) ask the adolescent to obtain an intermediate glucometer reading
c) inform the adolescent that a complex carbohydrate such as cheese should be taken
d) tell the adolescent that a prescribed dose of rapid acting insulin should be administered
a) encourage the adolescent to start exercising-although exercise does decrease insulin requirements and does lower blood glucose levels, the immediate action of insulin is needed
b) ask the adolescent to obtain an intermediate glucometer reading-this action will not correct the problem; the blood glucose level is already known
c) inform the adolescent that a complex carbohydrate such as cheese should be taken- food intake at this time will increase the level of blood glucose (also note that cheese does not contain complex carbohydrate)
d) tell the adolescent that a prescribed dose of rapid acting insulin should be administered-a blood glucose level of 180 mg/dl is above the average range, and the prescribed rapid acting insulin is needed

6. Page 263-Q 36-what information should the nurse include when teaching a client with heart disease about cholesterol
a) can be found in both plant and animal sources
b) causes an increase in serum high density lipoprotein
c) should be eliminated because it causes the disease process
d) decreases when unsaturated fats are substituted for saturated fats
a) animal only
b) exercise and not dietary cholesterol increases HDL-c
c) saturated fats are more of the problem in elevating serum cholesterol and as well cholesterol is already made in the body and turned into pro-vitamin D3, hormones (adrenocortical and sex steroid) and bile salts
d) correct- dietary unsaturated fats decrease serum cholesterol while dietary saturated fats increase serum cholesterol

7. Page 263-Q 37.-which instructions should the nurse include in the teaching plan for a client with hyperlipidemia who is be discharged with a prescription for cholestyramine (Questran)?
a) increase your intake of fibre and fluid
b) take the medication before you go to bed
c) check your pulse before taking your medications
d) contact your health care provider if your skin or sclera turn yellow
a) most common adverse effect of cholestyramine is constipation- fluid and fibre help reduced constipation by providing bulk to faeces
b) medication should be taken with meals
c) pulse is not affected by cholestyramine
d) cholestyramine binds bile in the intestine and therefore reduces the incidence of jaundice

8. page 263-Q 38- A nurse is providing dietary insruction to a client with cardiovascular disease. Which dietary selection by the client indicates the need for further instruction?
a) whole milk with oatmeal
b) garden salad with olive oil
c) tuna fish with small apple
d) soluble fibre cereal with skim milk
a) although oatmeal is a soluble fibre, whole milk is high in saturated fat and should be avoided
b) olive oil contains unsaturated fat including the cholesterol lowering oleic acid
c) most fish have a low fat content; the omega 3 content of fish helps lower triglycerides and platelet reactivity which contributes to myocardial infarction risk reduction
d) soluble fibre helps to lower cholesterol, skim milk does not contain fat.

9. d) red meats such as beef e) vegetables and whole grains
Page 263-Q39- A nurse asks a client with ischemic heart disease to identify the foods that are most important to restrict. The nurse determines that the client understands the dietary instructions when the client identifies the following foods. Select all that apply.
a) olive oil
b) chicken broth
c) enriched whole milk
d) red meats such as beef
e) vegetables and whole grains
f) liver and other glandular organ meats
a) unsaturated fat which is an healthy choice
b) this is high in sodium and should be avoided to prevent fluid retention and elevated blood pressure
c) this is high in saturated fats and contributes to hyperlipidemia; skim milk is the healthier choice
d) these are high in saturated fats and should be avoided
e) vegetables and grains are low in fat and have soluble fibre which may reduce the risk for heart disease
f) these are high in cholesterol and should be avoided

10. PAGE 266-Q 80-What dietary choices should the nurse instruct the client taking spironolactone (Aldalactone) to avoid?
a) potatoes
b) red meat
c) cantaloupe
d) wheat bread
e) flavoured yoghurt
a and c- spironolactone (Aldalactone) is a potassium sparing drug and therefore beverages and foods containing potassium such as potatoes, cantaloupe, bananas, avocadoes, oranges, dates, apricots and raisins should be avoided
b) red meat needs to be limited for other reasons not related to spironolactone
d) whole grains are associated with the relief of constipation and should not be avoided
e) dairy products are rich in sodium and calcium; spironolactone may cause hyponatremia