Nursing Elites

1. Each of the following accurately describes aspects of the dietary reference intakes (DRIs) published by the Food and Nutrition Board of the Institute of Medicine (IOM) except one. Which one is the exception?

• A. The DRIs replace the older recommended daily allowances
• B. Current DRIs attempt to estimate required nutrients to improve long-term health
• C. DRIs specifically address individuals whose requirements are affected by a disease state
• D. The DRIs attempt to establish maximum safe levels of tolerance for nutrients

Correct answer: C

Rationale: The correct answer is C. DRIs are intended for the general population and do not specifically address disease states, which are managed with different clinical guidelines. Choice A is correct as DRIs have replaced the older recommended daily allowances. Choice B is correct as current DRIs aim to estimate the required nutrients for long-term health. Choice D is correct as DRIs also attempt to establish maximum safe levels of tolerance for nutrients.

2. What is the fundamental difference between nursing diagnoses and collaborative problems?

• A. Collaborative problems are managed by nurses using physician-prescribed interventions.
• B. Collaborative problems can be addressed by independent nursing interventions.
• C. Physician-prescribed interventions are incorporated into nursing diagnoses.
• D. Nursing diagnoses include physiologic complications that nurses monitor to detect status changes.

Correct answer: B

Rationale: The correct answer is B, as collaborative problems necessitate the collective expertise and skills of numerous healthcare professionals, including nurses. These problems can be dealt with through independent nursing interventions in cooperation with other team members. Option A is incorrect because collaborative problems aren't strictly managed with physician-prescribed interventions. Option C is incorrect because nursing diagnoses aim at identifying and treating actual or potential health issues, rather than merely integrating physician-prescribed interventions. Option D is incorrect because nursing diagnoses aim at identifying patient issues, not solely physiologic complications, and guide the necessary nursing care, not just monitor for changes.

3. Which food should the nurse recommend for a client deficient in vitamin A?

• A. Orange slices
• B. Steamed carrots
• C. Apple sauce
• D. Baked potato

Correct answer: B

Rationale: The correct answer is B, steamed carrots, as they are high in vitamin A. Carrots are rich in beta-carotene, a precursor to vitamin A, which is essential for good vision, a healthy immune system, and cell growth. Oranges (choice A) are a good source of vitamin C but not vitamin A. Apple sauce (choice C) and baked potato (choice D) do not provide significant amounts of vitamin A compared to steamed carrots, making them less suitable recommendations for a client deficient in this specific nutrient.

4. Each statement is true of vitamin K, except one. Which is the exception?

• A. Vitamin K is produced in the gut.
• B. Vitamin K functions as a catalyst for the synthesis of blood-clotting factors.
• C. Vitamin K maintains prothrombin levels.
• D. Vitamin K absorption increases with high levels of vitamin E supplementation.

Correct answer: D

Rationale: The correct answer is D. Vitamin K absorption decreases with high levels of vitamin E supplementation because in larger amounts, vitamin E acts as an anticoagulant. Vitamin K is not produced in the gut but can be obtained from food sources or supplements. Vitamin K is essential for the synthesis of blood-clotting factors and is crucial in maintaining prothrombin levels, which is vital for proper blood clotting. The incorrect choice, D, is misleading as high levels of vitamin E supplementation hinder vitamin K absorption due to its anticoagulant properties. Dental hygienists should be aware of the importance of vitamin K in blood clotting, especially when treating patients who are on anticoagulant medications for conditions like stroke prevention.

5. Which metabolic disease is characterized by poor healing, severe forms of periodontal disease, necrosis, xerostomia, and candidiasis?

• A. Hypopituitarism
• B. Diabetes mellitus
• C. Hyperthyroidism
• D. Renal disease

Correct answer: B

Rationale: Diabetes mellitus is the correct answer. It is associated with poor wound healing, severe periodontal disease, tissue necrosis, dry mouth (xerostomia), and an increased susceptibility to oral infections like candidiasis. Hypopituitarism, hyperthyroidism, and renal disease are not typically linked to the specific oral manifestations described in the question.

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