Nursing Elites

1. Which of the following is a factor that affects Basal Metabolic Rate (BMR)?

• A. Age
• B. Sleep
• C. Fasting/Starvation
• D. All of the above

Correct answer: D

Rationale: All the listed options (Age, Sleep, Fasting/Starvation, Activity Level) are factors that can affect a person's Basal Metabolic Rate (BMR). BMR is the number of calories your body needs to accomplish its most basic (basal) life-sustaining functions. Age can affect BMR as metabolism slows with age. Sleep can influence BMR as metabolism slows during sleep. Fasting or starvation can decrease BMR as the body conserves energy. Activity level can also influence BMR; the more active you are, the higher your BMR, as your body requires more energy for physical activities.

2. Which organ produces and secretes bicarbonate ions and insulin?

• A. Stomach
• B. Pancreas
• C. Large intestine
• D. Small intestine

Correct answer: B

Rationale: The pancreas is the correct answer because it performs two vital functions: producing bicarbonate ions to neutralize stomach acid in the small intestine and secreting insulin to regulate blood glucose levels. The stomach is incorrect because its primary function is to break down and digest food, not produce bicarbonate ions or insulin. The large and small intestines are also incorrect because their primary functions are to absorb nutrients and water from food, rather than producing bicarbonate ions or insulin.

3. When assessing Richard for chest percussion or chest vibration and postural drainage, Mario would focus on the following EXCEPT:

• A. Amount of food and fluid taken during the last meal before treatment
• B. Respiratory rate, breath sounds, and location of congestion
• C. Teaching the client's relatives to perform the procedure
• D. Doctor's order regarding position restrictions and client's tolerance for lying flat

Correct answer: B

Rationale: The correct answer is B because when assessing Richard for chest percussion or chest vibration and postural drainage, Mario would focus on various aspects such as the amount of food and fluid taken before treatment to prevent complications during the procedure, teaching the client's relatives to perform the procedure correctly, and following the doctor's orders regarding position restrictions and the client's tolerance for lying flat. Respiratory rate, breath sounds, and location of congestion would be assessed during the procedure itself, not as part of the pre-assessment.

4. The nurse is caring for an infant whose parent reports the infant takes a bottle to go to sleep. What should the nurse instruct to prevent baby bottle tooth decay?

• A. Water
• B. Milk
• C. Iron-fortified formula
• D. Unsweetened fruit juice

Correct answer: A

Rationale: The correct answer is A, Water. Water is recommended to prevent baby bottle tooth decay caused by sugary substances present in milk, formula, or fruit juice. Water does not contain sugars that can contribute to tooth decay, unlike the other options. Milk, formula, and unsweetened fruit juice can all lead to tooth decay if the baby falls asleep with them in their mouth, as the sugars can linger on the teeth and cause decay over time. Iron-fortified formula, although beneficial for the infant's nutrition, still contains sugars that can be harmful to the teeth.

5. A client with cirrhosis and ascites is being cared for by a nurse. Which of the following interventions should the nurse include in the plan of care?

• A. Decrease the client's fluid intake.
• B. Increase the client's saturated fat intake.
• C. Increase the client's sodium intake.
• D. Decrease the client's carbohydrate intake.

Correct answer: D

Rationale: In a client with cirrhosis and ascites, decreasing carbohydrate intake is essential as it helps reduce the production of ascitic fluid. Excess carbohydrates can lead to fluid retention. Choices A, B, and C are incorrect. Decreasing fluid intake can worsen dehydration, increasing saturated fat intake is not recommended due to its impact on liver health, and increasing sodium intake can worsen fluid retention and exacerbate ascites in these clients.

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