Nursing Elites

1. Clients with type 2 diabetes are most likely to achieve metabolic control if they:

• A. lose weight
• B. use self-monitoring of blood glucose
• C. eliminate all dietary sugars
• D. eat three regular meals daily

Correct answer: A

Rationale: Weight loss improves insulin sensitivity and glycemic control, making it a key strategy in managing type 2 diabetes.

2. A nurse is developing a plan of care for a client who has anorexia nervosa. Which of the following actions should the nurse include in the plan?

• A. Encourage the client to participate in developing a system of rewards.
• B. Arrange for someone to remain with the client for 30 minutes after meals.
• C. Offer the client a selection of beverages at each meal.
• D. Inform the client that a weight gain of 2.3 kg per week is expected.

Correct answer: A

Rationale: Encouraging the client to participate in developing a system of rewards is an essential part of the plan of care for a client with anorexia nervosa. This action can help motivate and engage the client in their treatment plan, promoting a sense of achievement and progress. Choice B, arranging for someone to remain with the client for 30 minutes after meals, may not address the underlying issues related to anorexia nervosa and could potentially disrupt the client's independence. Choice C, offering a selection of beverages at each meal, is not directly related to addressing the client's condition of anorexia nervosa. Choice D, informing the client about an expected weight gain, could increase anxiety and may not be appropriate without considering the client's individual progress and readiness.

3. Nancy blames God for her situation. She is easily provoked to tears and wants to be left alone, refusing to eat or talk to her family. A religious person before, she now refuses to pray or go to church stating that God has abandoned her. The nurse understands that Nancy is grieving for her self and is in the stage of:

• A. bargaining
• B. denial
• C. anger
• D. acceptance

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.

4. What is one of the best nutritional actions a caregiver can take to help a patient with Alzheimer's disease maintain appropriate body weight?

• A. Thicken liquids to prevent choking
• B. Supervise food planning and mealtimes
• C. Assist the person in completing a grocery checklist
• D. Feed the person their meals and snacks

Correct answer: B

Rationale: The correct answer is B, 'Supervise food planning and mealtimes'. This action ensures the patient with Alzheimer's disease maintains an appropriate diet and body weight, thus reducing the risk of malnutrition. While choices A, 'Thicken liquids to prevent choking', C, 'Assist the person in completing a grocery checklist', and D, 'Feed the person their meals and snacks', might be beneficial in certain circumstances, they do not directly contribute to the maintenance of appropriate body weight as effectively as supervising food planning and mealtimes does.

5. 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.

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