Nursing Elites

1. A nurse is educating a group of older adults in a community center on weight management using the BMI scale. Using the client's height and weight to calculate BMI, which of the following clients has a healthy BMI?

• A. A client with a weight of 128 lb and height of 70 inches
• B. A client with a weight of 150 lb and height of 68 inches
• C. A client with a weight of 200 lb and height of 72 inches
• D. A client with a weight of 133 lb and height of 60 inches

Correct answer: A

Rationale: To determine a healthy BMI, we need to calculate it using the formula: BMI = weight (lbs) / height^2 (inches) x 703. For choice A, BMI = 128 / (70 x 70) x 703 = 18.38, which falls within the healthy BMI range of 18.5-24.9. Therefore, choice A is correct. Choices B, C, and D have BMIs of 22.8, 27.1, and 26.1, respectively, which are outside the healthy range. Thus, choices B, C, and D are incorrect.

2. Characteristics of type two diabetes include all of the following except:

• A. insulin resistance
• B. blood glucose levels that rise too high
• C. blood insulin levels that rise too high
• D. rapid destruction of the pancreas

Correct answer: D

Rationale: Type 2 diabetes is characterized by insulin resistance, high blood glucose levels, and high blood insulin levels. Rapid destruction of the pancreas is not a feature of this condition. The destruction of pancreatic beta cells is more commonly associated with type 1 diabetes, not type 2 diabetes. Therefore, option D is the correct answer. Options A, B, and C are all characteristic features of type 2 diabetes, making them incorrect choices.

3. In PEM, which condition is characterized by symptoms such as muscle weakness, hanging skin, delayed tooth eruption, and changes in saliva?

• A. Marasmus
• B. Kwashiorkor
• C. Anemia
• D. Noma

Correct answer: A

Rationale: The correct answer is Marasmus. Marasmus is a severe form of protein-energy malnutrition (PEM) that leads to muscle wasting, hanging skin, delayed growth, and changes in saliva. These symptoms are commonly seen in vulnerable populations such as children, homeless individuals, older adults, and substance abusers. Kwashiorkor, on the other hand, is characterized by edema, a distended belly, and skin lesions. Anemia is a condition characterized by a low red blood cell count, leading to fatigue and weakness. Noma is a severe infection affecting the face, particularly the mouth and jaw area.

4. A nurse is caring for a client following a CVA and observes the client experiencing severe dysphagia. The nurse notifies the provider. Which of the following nutritional therapies will likely be prescribed?

• A. NPO until dysphagia subsides
• B. Supplements via nasogastric tube
• C. Initiation of total parenteral nutrition
• D. Soft residue diet

Correct answer: B

Rationale: In the scenario of severe dysphagia following a CVA, the client may have difficulty swallowing and require alternative nutritional support. Providing supplements via a nasogastric tube allows for the delivery of essential nutrients directly into the stomach, bypassing the swallowing difficulties. NPO (nothing by mouth) until dysphagia subsides may be too restrictive for the client's nutritional needs. Initiation of total parenteral nutrition is usually reserved for cases where enteral feeding is not possible or contraindicated. A soft residue diet may not be suitable for a client experiencing severe dysphagia.

5. A client who practices Islam and is currently observing dietary restrictions for the month of Ramadan. Which of the following interventions should the nurse include in the plan of care?

• A. Remove pork products from the dietary plan
• B. Facilitate fasting during daylight hours
• C. Serve meat and dairy items together
• D. Provide a low-carb diet on Fridays

Correct answer: B

Rationale: During Ramadan, individuals fast from dawn to sunset. Facilitating fasting during daylight hours respects the dietary practices of clients observing Ramadan. Choice A is incorrect as the dietary restriction during Ramadan involves abstaining from all food and drink during daylight hours, not just beef products. Choice C is incorrect as Muslims generally do not consume meat and dairy together due to religious dietary laws. Choice D is incorrect as providing a low-carb diet on Fridays does not specifically align with the dietary restrictions observed during Ramadan.

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