Nursing Elites

1. When assessing older adult clients for malnutrition at an adult day care center, which risk factors should the nurse consider?

• A. Dental problems
• B. Depression
• C. Both A and B
• D. Ability to prepare meals

Correct answer: C

Rationale: The correct answer is C: Both A and B. Dental problems and depression are both significant risk factors for malnutrition in older adults. Dental problems can lead to difficulty in chewing and swallowing, resulting in reduced food intake. On the other hand, depression can cause changes in appetite and decreased interest in eating, which can also contribute to malnutrition. Although the ability to prepare meals is important, it is not specifically identified as a risk factor for malnutrition within the context of this question. Therefore, choices A and B are the most appropriate answers.

2. A condition that often progresses to become type 2 diabetes mellitus is:

• A. type 1 diabetes mellitus
• B. high blood pressure
• C. chronic pancreatitis
• D. impaired glucose tolerance

Correct answer: D

Rationale: Impaired glucose tolerance is a pre-diabetic state characterized by higher than normal blood sugar levels. It is often associated with insulin resistance and can progress to type 2 diabetes mellitus. Type 1 diabetes mellitus (Choice A) is an autoimmune condition where the body attacks insulin-producing cells, leading to a lack of insulin production. High blood pressure (Choice B) and chronic pancreatitis (Choice C) are not directly linked to the progression to type 2 diabetes mellitus.

3. The nurse is completing a nutritional assessment on a client. Which statement made by the client is most concerning to the nurse?

• A. "I notice when I take a vitamin E supplement, I bruise more easily."
• B. "I work nights and rarely go outside during the day."
• C. "I take warfarin, so I need to limit the amount of green leafy vegetables I eat."
• D. "My vitamin supplement has the recommended daily allowance of vitamin A."

Correct answer: A

Rationale: The correct answer is A. Excessive intake of vitamin E can increase the risk of bleeding as it acts as a blood thinner. Bruising easily may indicate too much vitamin E. Choice B is not as concerning as it describes a lifestyle that may lead to vitamin D deficiency due to lack of sunlight exposure. Choice C shows awareness of the interaction between warfarin and vitamin K, which is expected. Choice D indicates knowledge of the vitamin A content in the supplement, which is not a cause for concern.

4. To successfully complete the tasks of older adulthood, an 85 year old who has been a widow for 25 years should be encouraged to:

• A. Invest her creative energies in promoting social welfare
• B. Redefine her role in the society and offer something and offer something of value
• C. Feel a sense of satisfaction in reflecting on her productive life
• D. Look to recapture the opportunities that were never started or completed

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

5. Risk factors that have been shown to contribute to age-related macular degeneration include _____.

• A. oxidative stress from sunlight
• B. iron-deficiency anemia
• C. decreased intake of phytochemicals
• D. vitamin B6 malabsorption

Correct answer: A

Rationale: The correct answer is A: oxidative stress from sunlight. Oxidative stress caused by exposure to sunlight is a significant risk factor for age-related macular degeneration. This condition can result in vision loss among older individuals. Choices B, C, and D are incorrect. Iron-deficiency anemia, decreased intake of phytochemicals, and vitamin B6 malabsorption are not established risk factors for age-related macular degeneration.

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