Nursing Elites

1. A client with a history of pancreatitis is being taught by a nurse. Which of the following food choices should the nurse instruct the client to avoid?

• A. Noodles
• B. Vegetable Soup
• C. Baked Fish
• D. Cheddar cheese

Correct answer: D

Rationale: Patients with pancreatitis should avoid high-fat foods like cheddar cheese as they can exacerbate symptoms due to the organ's role in fat digestion. Noodles, vegetable soup, and baked fish are generally considered to be lower in fat content and are thus safer choices for individuals with pancreatitis.

2. Which cells in the islet of the pancreas are responsible for synthesizing insulin?

• A. Alpha cells
• B. Beta cells
• C. Gamma cells
• D. Delta cells

Correct answer: B

Rationale: Beta cells in the islets of Langerhans in the pancreas are responsible for the production and secretion of insulin, which is crucial for regulating blood glucose levels. Alpha cells, on the other hand, produce glucagon, a hormone that raises blood glucose levels. Gamma cells and Delta cells do not exist in the islets of Langerhans; therefore, they are incorrect choices.

3. What are symptoms of uncontrolled type 1 diabetes?

• A. Depression, anxiety, and fatigue
• B. Increased thirst, urination, and hunger
• C. Weight gain, macrosomia, and food cravings
• D. Poor wound healing, blurred vision, and recurrent infections

Correct answer: B

Rationale: The correct answer is B: Increased thirst, urination, and hunger. Uncontrolled type 1 diabetes typically presents with classic symptoms including polydipsia (increased thirst), polyuria (frequent urination), and polyphagia (increased hunger). These symptoms are often accompanied by weight loss due to the body's inability to properly utilize glucose for energy. Choices A, C, and D are incorrect as they do not align with the typical symptoms of uncontrolled type 1 diabetes. Depression, anxiety, fatigue, weight gain, macrosomia, food cravings, poor wound healing, blurred vision, and recurrent infections are not primary symptoms associated with uncontrolled type 1 diabetes.

4. A healthcare professional is reviewing the laboratory findings of a client who has heart failure. Which of the following findings indicates that the client is experiencing fluid volume excess?

• A. BUN 8 mg/dL
• B. Hgb 15 g/dL
• C. Creatinine 0.8 mg/dL
• D. Sodium 140 mEq/L

Correct answer: A

Rationale: A BUN level of 8 mg/dL indicates fluid volume excess in a client with heart failure. BUN (Blood Urea Nitrogen) levels can be low in fluid overload due to hemodilution, a common occurrence in heart failure. High levels of BUN usually indicate dehydration or impaired renal function, which are not the case in fluid volume excess. Choices B, C, and D are within normal ranges and do not specifically indicate fluid volume excess.

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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