Nursing Elites

1. Dietary fiber has been recommended for its possible benefits in reducing heart disease by lowering blood cholesterol. How is fiber thought to play its role in lowering blood cholesterol?

• A. Insoluble fiber binds with cholesterol in the large intestine and is excreted in feces
• B. Viscous fiber binds with bile in the intestine and is excreted in feces
• C. Soluble fiber binds with cholesterol in the blood and is excreted by the liver
• D. Insoluble fiber converts to bile in the large intestine and binds with cholesterol

Correct answer: B

Rationale: The correct answer is B. Viscous (soluble) fiber binds with bile acids in the intestine, which are then excreted. The liver must use cholesterol to make more bile acids, thereby lowering blood cholesterol levels. Choice A is incorrect as insoluble fiber does not bind with cholesterol in the large intestine. Choice C is incorrect as soluble fiber does not directly bind with cholesterol in the blood. Choice D is incorrect as insoluble fiber does not convert to bile in the large intestine to bind with cholesterol.

2. A patient following a vegetarian diet might be at risk for deficiency in which nutrient?

• A. Vitamin C
• B. Vitamin B12
• C. Vitamin A
• D. Vitamin D

Correct answer: B

Rationale: Vitamin B12 is primarily found in animal products, so vegetarians may need supplementation.

3. You are an ostomy nurse and you know that colostomy is defined as:

• A. It is an incision into the colon to create an artificial opening to the exterior of the abdomen
• B. It is end to end anastomosis of the gastric stump to the duodenum
• C. It is end to end anastomosis of the gastric stump to the jejunum
• D. It is an incision into the ileum to create an artificial opening to the exterior of the abdomen

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

4. Which factor has been shown to increase the risk of development of atherosclerosis?

• A. Menopause
• B. Age older than 35
• C. Increased levels of arachidonic acid
• D. Elevated HDL cholesterol

Correct answer: A

Rationale: The correct answer is A: Menopause. Menopause is associated with an increased risk of atherosclerosis due to hormonal changes that affect lipid profiles and vascular health. Conversely, B: Age older than 35 is not necessarily a risk factor for atherosclerosis on its own, though atherosclerosis risk does generally increase with age. C: Increased levels of arachidonic acid is not specifically linked to atherosclerosis; it's a fatty acid that can be both beneficial and harmful to health depending on its metabolic pathway. D: Elevated HDL cholesterol is actually beneficial rather than harmful because HDL cholesterol is known as 'good' cholesterol that helps to reduce the risk of heart disease and atherosclerosis.

5. A client who is experiencing dumping syndrome following gastric surgery is receiving education from a nurse. Which of the following statements by the client indicates an understanding of the teaching?

• A. I should drink additional fluids with my meals.
• B. I should eat high-fiber snacks between meals.
• C. I should eat a protein source with each meal.
• D. I can have caffeinated beverages in small amounts.

Correct answer: C

Rationale: The correct answer is C. Eating a protein source with each meal can help manage dumping syndrome by slowing gastric emptying and reducing symptoms. This choice is the most appropriate as it directly addresses a key dietary recommendation for dumping syndrome. Choices A, B, and D are incorrect because drinking additional fluids with meals, eating high-fiber snacks between meals, and consuming caffeinated beverages can exacerbate dumping syndrome symptoms by increasing gastric emptying and worsening the condition.

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