Nursing Elites

1. For a patient with GERD (gastroesophageal reflux disease), which dietary advice is most appropriate?

• A. Increase spicy foods
• B. Avoid fatty foods
• C. Increase citrus fruits
• D. Reduce water intake

Correct answer: B

Rationale: Avoiding fatty foods can help reduce the symptoms of GERD.

2. Vitamin deficiencies, especially the B-complex vitamins, seldom occur in isolation. Folate, a B-complex vitamin, is the exception because it functions separately from other vitamins.

• A. Both statements are true.
• B. Both statements are false.
• C. The first statement is true; the second is false.
• D. The first statement is false; the second is true.

Correct answer: C

Rationale: The first statement is true; the second is false. If a deficiency of one vitamin is suspected, symptoms of other vitamin B deficiencies also may be present. Folate deficiencies usually occur with other nutrient deficiencies. Specifically, folate functions in conjunction with vitamins B12 and C in maintaining normal levels of mature red blood cells.

3. What happens when Mrs. Guevarra, a nurse, delegates aspects of the client's care to the nurse-aide, an unlicensed staff member?

• A. Mrs. Guevarra makes the assignment to instruct the staff member
• B. Mrs. Guevarra is assigning the responsibility to the aide but not the accountability for those tasks
• C. Mrs. Guevarra does not need to directly supervise or evaluate the aide
• D. Mrs. Guevarra must know how to perform the task being delegated

Correct answer: C

Rationale: The correct answer is C. While it is true that Mrs. Guevarra is delegating tasks to the nurse-aide, she does not necessarily have to directly supervise or evaluate the aide. She still retains the overall accountability for the care of the client, but direct supervision of the aide is not a requirement for delegation. Choice A is incorrect because the primary purpose of delegation is not instruction. Choice B is also incorrect because although Mrs. Guevarra is delegating tasks, she still retains accountability for those tasks. Finally, choice D is incorrect because the ability to perform the task being delegated is not a requirement for the delegator; the delegatee should have the necessary skills and knowledge to perform the delegated tasks.

4. Which enzyme is most essential for hydrolyzing large protein molecules?

• A. Gastric lipase
• B. Pepsin
• C. Mucus
• D. Intrinsic factor

Correct answer: B

Rationale: Pepsin, choice B, is the correct answer as it is a proteolytic enzyme that is essential for the breakdown of large protein molecules in the stomach. Gastric lipase, choice A, is incorrect because it primarily targets fats, not proteins, hence it is not involved in protein hydrolysis. Mucus, choice C, is incorrect as it serves to protect the stomach lining from acidic gastric juices and does not play a direct role in protein digestion. Intrinsic factor, choice D, is incorrect as it is vital for the absorption of Vitamin B12 in the small intestine and doesn't participate in the process of hydrolyzing proteins.

5. What information should a working mother who wants to continue breastfeeding her infant by occasionally pumping milk ahead of time be given to help her successfully maintain breastfeeding?

• A. Breast milk can be refrigerated for up to 4 days
• B. Breast milk stored in a deep freezer can be kept for up to 12 months
• C. Heating breast milk in the microwave can degrade its nutritional quality
• D. Breast milk can be expressed either by hand or with an electric pump

Correct answer: D

Rationale: The correct answer is D. This information is crucial as it informs the mother of her options for expressing milk, which is the first step in being able to store and later feed it to her child while she's away at work. Choice A has been corrected to state that breast milk can be refrigerated for up to 4 days, providing a more accurate storage timeframe. Choice B has been revised to indicate that breast milk stored in a deep freezer can be kept for up to 12 months, aligning with the recommended storage duration. Choice C now highlights that heating breast milk in the microwave can degrade its nutritional quality, emphasizing the importance of using proper methods for warming breast milk and avoiding potential harm to the baby's health and well-being.

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