Nursing School Confidential

A question on a test today about celiac disease. It went something like this:
The nurse knows her teaching about celiac disease to the mother of a newly diagnosed five-year-old has been effective when the mother says she will choose which of the following for the child’s snack:
A. Peanut butter and banana sandwich.
B. Oven-baked potato chips and cola.
C. Oatmeal cookie and glass of milk.
D. Graham crackers and an apple.
You scan the choices for something blatantly gluten free.
A. Peanut butter and banana sandwich could be the right answer. If the bread for the PB&B sandwich contained gluten, wouldn’t it say it’s on wheat bread? Usually these questions describe creepy things like “baked fish on wheat toast with margarine,” or “turkey patty on light wheat bread with sesame seeds.” The question was probably written within the past five years, and GF bread has been ubiquitous that whole time. So why would you assume the sandwich is on wheat bread if it doesn’t say so? Maybe the idea is to test whether you know that “sandwich” doesn’t = gluten, and that the child can continue to eat most of her favorite foods. So maybe A.
B. Chips and cola = gluten free, but… Wait! It’s got to be a trap. A child with celiac disease needs nourishment more than anyone, trudging along as they have been with their crapped-out villi. You go back to the question and imagine the scene: the nurse has been teaching the mom and the mom says she’s going to give the kid chips and soda for a snack. WTF? That can’t be right. That sucks. There is no way the right answer would be devoid of nutrition. It’s gluten free, but this can’t be it.
C. Oatmeal cookie and milk. Hmm. You know imaginary nurses in nursing school questions do like to recommend milk. This may be too deep, and was definitely not in the lecture or the reading, but if the child was just diagnosed, the family would be warned about possible lactose intolerance or sensitivity to milk while the gut heals. So the milk is either a trap or a clue. Enough on the milk. What about the cookie? Even if it is gluten free, and no one’s saying either way, oatmeal—even if it is certified GF oatmeal—is so controversial. Milk and oatmeal were not addressed in the two minutes we spent on celiac disease, but compared to the PB&B sandwich, which merely has possible wheat in the bread, this snack has three issues: possible wheat in the cookie, and then the thornier issues of oats and milk. So this can not be it.
D. Graham crackers and an apple. First of all: carbs. Then you remember no one cares about that but you. A graham cracker contains gluten. There are gluten free graham crackers, but those are called graham style crackers. So not D.
So A. It’s the only possibility. Well, C is possible, but less nutrition-y and with more issues.
But in nursing school test world, is it B? You’re pretty sure the idea is to simply find the gluten free choice and move on. Ugh, but B is so wrong. Don’t give a malnourished child chips and soda. Give them a nice banana and peanut butter sandwich. Maybe toss a few of those potato chips on the side.
IRL, the nurse would tell the mom sandwiches are entirely possible, even the Target on Route 6 has at least three brands of gluten free bread, this won’t be so bad, please feed your child like a normal person.
But in the end I chose B: chips and soda for the sprued-up lass. I got it right.
That is gross.
I feel so dirty.


  1. Polina · April 28, 2016


    What about sting cheese and apple? Or a slice of turkey and banana? Or a lettuce wrap? Or apple slices and peanut butter? SO.MANY.OPTIONS. Foods that are and have always been gluten-free. Especially when you don’t have to worry about carbs.

    This is really really stupid. Like, really.

    Liked by 1 person

  2. gstabach · April 28, 2016

    Our healthcare system I s whack! (I hope I’m using that correctly!)

    Liked by 1 person

  3. skchrisman · April 29, 2016

    Ungh! Puh-leaz! You should have stood up, turned that two-minute lesson into an informative one-hour lesson so those nursing students could leave having learned a thing or two or twenty and that of all the dumb possible answers, chips and soda should never be the advice of a nurse. Unless you’re trying to cure a girl of a boy issue “Gilmore Girl” style.

    Liked by 1 person

  4. Scott E · April 29, 2016

    Another, equally valid response would’ve been “E: This very test paper and Ticonderoga #2 pencil”. At least that contains some nutritious fiber. (Do they still take tests with paper and pencil these days? My son took the PARCC test using a Chromebook. Maybe that can be a GF snack. Though an Apple computer sounds more food-like. My head is spinning – I feel so old…)

    Liked by 1 person

  5. Laddie · April 29, 2016

    Ugh! I think I would like the food from Polina’s comment.

    Liked by 1 person

  6. StephenS · April 29, 2016

    Hmmm… medicine. But: glad I came back to your blog. It’s been too long.

    Liked by 1 person

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