Nursing Elites

1. A nurse is providing teaching to a client with gastroesophageal reflux. Which of the following statements by the client indicates a need for further teaching?

• A. I should elevate the head of my bed while sleeping.
• B. I drink no more than 4 cups of coffee a day.
• C. I take my time when I am eating.
• D. I avoid foods and drinks made with chocolate.

Correct answer: B

Rationale: The correct answer is B: 'I drink no more than 4 cups of coffee a day.' Excessive coffee consumption can aggravate gastroesophageal reflux due to its acidic nature. Choices A, C, and D are all appropriate self-care measures for managing gastroesophageal reflux. Elevating the head of the bed while sleeping helps prevent acid reflux, eating slowly can reduce reflux episodes, and avoiding trigger foods like chocolate can help alleviate symptoms.

2. A healthcare provider is on a med-surg unit caring for a client who follows the dietary laws of Orthodox Judaism. Which of the following menu selections should the healthcare provider recommend for this client?

• A. Fried catfish
• B. Broiled shrimp
• C. Pork sausage
• D. Grilled vegetables

Correct answer: D

Rationale: The correct answer is D: Grilled vegetables. Orthodox Judaism restricts the consumption of certain animals, including catfish, shrimp, and pork, making choices A, B, and C inappropriate for a client following these dietary laws. Grilled vegetables are a safe and suitable option that complies with Orthodox Jewish dietary guidelines.

3. Which type of immunity is demonstrated by the transfer of a mother's immunoglobulin across the placenta to protect the child?

• A. Natural active immunity
• B. Natural passive immunity
• C. Artificial active immunity
• D. Artificial passive immunity

Correct answer: B

Rationale: The immunoglobulin passed from the mother to the child through the placenta is an example of natural passive immunity, making choice B the correct answer. This transfer gives the child temporary immunity to various diseases without their immune system having to work. On the other hand, natural active immunity (Choice A) occurs when the body produces its own antibodies in response to an antigen. Artificial active immunity (Choice C) is achieved through vaccinations, where the immune system is stimulated to produce antibodies against a specific disease. Artificial passive immunity (Choice D) is a temporary immunity that involves the transfer of pre-formed antibodies from another source.

4. Which vitamin acts most like a hormone?

• A. Vitamin A
• B. Vitamin B
• C. Vitamin D
• D. Vitamin C

Correct answer: C

Rationale: The correct answer is Vitamin D. Although vitamin D, also known as calciferol, has been called a vitamin, it is more appropriately classified as a hormone. Like hormones, vitamin D acts to control the function of other cell types. For example, it helps the body absorb and regulate skeletal calcium and phosphorus levels. Choice A (Vitamin A) plays a crucial role in vision and immune function. Choice B (Vitamin B) is a complex of different vitamins that play various roles in the body. Choice D (Vitamin C) is important for collagen production and acts as an antioxidant.

5. For a patient on a ketogenic diet, which macronutrient is primarily increased?

• A. Carbohydrates
• B. Protein
• C. Fats
• D. Fiber

Correct answer: C

Rationale: The correct answer is C: Fats. A ketogenic diet is characterized by high fat intake, moderate protein intake, and very low carbohydrate intake. This diet aims to shift the body's metabolism to use fat as the primary source of energy instead of carbohydrates. Increasing fat intake while reducing carbohydrates is essential for achieving and maintaining a state of ketosis. Therefore, choices A, B, and D are incorrect as they do not align with the macronutrient adjustments required for a ketogenic diet.

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