Nursing Elites

1. Which of the following converts starch to disaccharides, and this reaction occurs in the _____?

• A. pancreatic amylases, small intestine
• B. brush border enzymes, small intestine
• C. luminal enzymes, large intestine
• D. pancreatic amylases, pancreas

Correct answer: A

Rationale: The correct answer is A. Pancreatic amylases break down starch into disaccharides in the small intestine. This process occurs in the small intestine, not the large intestine or pancreas. Brush border enzymes act on disaccharides to break them down into monosaccharides, while luminal enzymes are not specifically involved in the conversion of starch to disaccharides.

2. A nurse is caring for a client following an appendectomy. The nurse verifies the postoperative prescription which reads, 'Discontinue NPO status; advance diet as tolerated.' Which of the following are appropriate for the nurse to offer the client? (SATA)

• A. Wheat toast
• B. Applesauce
• C. Applesauce, Chicken broth
• D. Chicken broth

Correct answer: C

Rationale: The correct answer is C: Applesauce and chicken broth. After an appendectomy, patients are typically started on a clear liquid diet before advancing to more solid foods. Applesauce and chicken broth are part of a low-residue diet that is easily digestible and gentle on the digestive system, making them suitable choices for a client following surgery. Wheat toast may be too heavy and fibrous initially, while other solid foods should be introduced gradually to prevent gastrointestinal upset.

3. What is the most effective way to limit the number of microorganisms in the hospital?

• A. Using strict aseptic technique in all procedures
• B. Wearing a mask and gown when caring for all patients with communicable diseases
• C. Sterilizing all instruments
• D. Handwashing

Correct answer: A

Rationale: The most effective way to limit the number of microorganisms in the hospital is by using strict aseptic technique in all procedures. This approach ensures that the risk of introducing harmful microorganisms into the hospital environment or patients is minimized. Choice B, wearing a mask and gown when caring for patients with communicable diseases, is important but not as comprehensive as using aseptic technique in all procedures. Sterilizing all instruments (Choice C) is crucial for preventing infections but may not address all avenues of microorganism transmission. Handwashing (Choice D) is a fundamental practice in infection control but alone may not be as effective as utilizing aseptic techniques in all procedures to limit microorganisms in the hospital.

4. A client with Crohn's disease is receiving parenteral nutrition. Which of the following interventions should the nurse not include in the care of this client?

• A. Remove the parenteral nutrition solution from the refrigerator 2 hours before infusion.
• B. Remove unused parenteral nutrition after 12 hours of use.
• C. Monitor daily laboratory values and report abnormalities as needed.
• D. Monitor the flow rate of the parenteral nutrition carefully and adjust it if necessary.

Correct answer: B

Rationale: In caring for a client receiving parenteral nutrition, it is important to follow proper guidelines to ensure safety and effectiveness. Unused parenteral nutrition should be removed after 24 hours, not 12 hours, to prevent contamination and reduce the risk of infection. Option A is correct as it ensures the solution is at room temperature before infusion. Option C is essential for monitoring the client's response to parenteral nutrition. Option D is important to maintain the correct flow rate and adjust it as needed. Therefore, option B is the incorrect choice among the options provided.

5. Why are blood glucose levels high in type 1 diabetes?

• A. The urinary excretion of glucose is impaired
• B. The lean body mass is metabolized to produce glucose via gluconeogenesis
• C. The absorption of glucose from the gastrointestinal tract is more efficient
• D. There is insufficient insulin to facilitate the transport of glucose into the cells

Correct answer: D

Rationale: In type 1 diabetes, the body's immune system destroys the beta cells in the pancreas that produce insulin. This leads to an insufficient amount of insulin, which is required to facilitate the transport of glucose into the cells. Consequently, blood glucose levels remain high. The other options are incorrect. Option A is incorrect because urinary excretion of glucose does not directly contribute to blood glucose levels. Option B is incorrect because, while gluconeogenesis does produce glucose, it is not the cause of high glucose levels in type 1 diabetes. Option C is incorrect because absorption efficiency of glucose from the gastrointestinal tract does not affect the amount of insulin available to transport glucose into cells.

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