Nursing Elites

1. An elderly man is hospitalized with a diagnosis of malnutrition three months following his wife's death. What risk factor for malnutrition does this scenario illustrate?

• A. A history of chronic illness
• B. Depression or social isolation
• C. Age
• D. Impaired mobility

Correct answer: B

Rationale: This scenario illustrates depression or social isolation as a risk factor for malnutrition. After the death of his wife, the elderly man may have experienced depression or social isolation, which can lead to decreased food intake and poor nutritional status. Although age, chronic illness, and impaired mobility can also contribute to malnutrition, they are not the primary factors described in this scenario. The history of chronic illness (Choice A) and impaired mobility (Choice D) were not mentioned in the scenario, and while age (Choice C) is a factor, it's not the main factor depicted in this case.

2. By force of law, therefore, the PRC-Board of Nursing released Resolution No. 14 Series of 1999 entitled: "Adoption of a Nursing Specialty Certification Program and Creation of Nursing Specialty Certification Council." This rule-making power is called:

• A. Quasi-Judicial Power
• B. Regulatory Power
• C. Quasi-Legislative Power
• D. Executive/Promulgating Power

Correct answer: B

Rationale: The correct answer is B: Regulatory Power. Regulatory power involves the authority to create rules and regulations that govern a specific area. In this case, the PRC-Board of Nursing's release of Resolution No. 14 Series of 1999 for the Nursing Specialty Certification Program falls under regulatory power as it establishes guidelines and standards for nursing specialty certification. Choices A, C, and D are incorrect. Quasi-judicial power involves making decisions on rights and obligations, quasi-legislative power involves creating regulations with the force of law, and executive/promulgating power involves enforcing and implementing laws and regulations.

3. The nurse is working with a patient who recently had a stroke. The patient frequently chokes and coughs when eating and is having difficulty feeding herself. What is the best way to ensure adequate nutrition?

• A. to have an aide feed her at each meal
• B. to ask a family member to assist during meals
• C. to provide tube feedings for the patient
• D. to initiate TPN for the patient

Correct answer: C

Rationale: The best way to ensure adequate nutrition for a stroke patient who frequently chokes and coughs when eating and has difficulty feeding herself is to provide tube feedings. Tube feedings are a safe and effective method to deliver nutrition directly to the stomach or intestines, bypassing the swallowing mechanism, reducing the risk of aspiration. Having an aide feed her each meal (choice A) may not address the underlying issue of swallowing difficulty and aspiration risk. Asking a family member to be present at each meal (choice B) does not provide a definitive solution to the patient's nutritional needs. Placing the patient on total parenteral nutrition (TPN) (choice D) is a more invasive and typically reserved for patients who cannot tolerate enteral feedings or have non-functional gastrointestinal tracts.

4. One of the most common factors that compromise the vitamin D status of older adults, particularly those living in assisted living communities is _____.

• A. decreased intake of fruits and vegetables
• B. lack of physical activity
• C. malabsorption due to atrophic gastritis
• D. lack of exposure to sunlight

Correct answer: D

Rationale: The correct answer is 'D: lack of exposure to sunlight.' Older adults, especially those in assisted living communities, are at risk of vitamin D deficiency due to spending most of their time indoors, which reduces their exposure to sunlight. Sunlight is essential for the body to produce vitamin D. Choices A, B, and C are less likely to be major factors in compromising vitamin D status. While a decreased intake of fruits and vegetables and lack of physical activity can impact overall health, they are not as directly related to vitamin D status. Malabsorption due to atrophic gastritis may affect the absorption of certain nutrients, but vitamin D synthesis primarily depends on sunlight exposure.

5. Which vitamin is essential for proper blood clotting?

• A. Vitamin A
• B. Vitamin E
• C. Vitamin K
• D. Vitamin C

Correct answer: C

Rationale: Vitamin K is vital for the synthesis of clotting factors, which are necessary for proper blood clotting. Vitamin A (Choice A) is important for vision and skin health, not blood clotting. Vitamin E (Choice B) is an antioxidant that helps protect cells from damage but is not directly involved in blood clotting. Vitamin C (Choice D) is essential for collagen synthesis and a healthy immune system, but it does not play a direct role in blood clotting.

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