Nursing Elites

1. Metabolic control is especially important for women with gestational diabetes to ensure the infant does not develop:

• A. microsomia
• B. macrosomia
• C. type 1 diabetes
• D. type 2 diabetes

Correct answer: B

Rationale: Metabolic control is crucial for women with gestational diabetes to prevent the development of macrosomia, which is characterized by an abnormally large baby. This condition poses risks such as birth injuries and necessitates careful management of blood sugar levels. Microsomia is not a known term related to this context. Type 1 and type 2 diabetes are not conditions the infant would develop as a result of gestational diabetes in the mother.

2. A client receiving total parenteral nutrition (TPN is awaiting the next container. What fluid should the nurse infuse in the interim?

• A. Dextrose 5% in water
• B. 0.9% sodium chloride
• C. Dextrose 10% in water
• D. Lactated Ringer's solution

Correct answer: B

Rationale: The correct answer is 0.9% sodium chloride. When a client receiving TPN is awaiting the next container, infusing 0.9% sodium chloride is the appropriate choice to maintain fluid and electrolyte balance. Dextrose solutions are not recommended as they do not provide sufficient nutrition. Lactated Ringer's solution contains electrolytes but lacks essential nutrients found in TPN, making it an inadequate choice during the delay in TPN delivery.

3. A nurse is caring for a client with a thiamine deficiency. Which assessment findings will the nurse expect?

• A. Tachycardia, muscle weakness, and lack of coordination
• B. Swollen lips, cracks in the corners of the mouth, and glossitis
• C. Neuropsychiatric symptoms of delusions and hallucinations
• D. Scaly rash on arms, dementia, and diarrhea

Correct answer: A

Rationale: Thiamine deficiency, also known as Vitamin B1 deficiency, can present with various symptoms. Tachycardia, muscle weakness, and lack of coordination are classic signs of thiamine deficiency due to its role in energy metabolism. Swollen lips, cracks in the corners of the mouth, and glossitis are more indicative of a deficiency in riboflavin (Vitamin B2). Neuropsychiatric symptoms of delusions and hallucinations are characteristic of niacin (Vitamin B3) deficiency. A scaly rash on the arms, dementia, and diarrhea are not typically associated with thiamine deficiency. Therefore, the correct assessment findings for a client with thiamine deficiency are tachycardia, muscle weakness, and lack of coordination.

4. Which enzyme initiates protein digestion in the stomach?

• A. Pepsin
• B. Salivary Amylase
• C. CCK
• D. Secretin

Correct answer: A

Rationale: Pepsin is the enzyme that initiates protein digestion in the stomach. It breaks down proteins into smaller peptides, aiding in their further digestion and absorption in the intestines. Salivary Amylase (Choice B) functions in breaking down dietary carbohydrates in the mouth, not proteins. CCK (Choice C) and Secretin (Choice D) are hormones involved in the digestion of fats and carbohydrates, not proteins. Therefore, Choices B, C, and D are incorrect in the context of protein digestion in the stomach.

5. Health practitioners evaluate disease progression in HIV-infected patients by measuring the concentrations of helper T cells and circulating virus, called _____.

• A. cross resistance
• B. the immune response
• C. acquired resistance
• D. the viral load

Correct answer: D

Rationale: The viral load is the measure of the amount of circulating virus in the blood and is used to evaluate the progression of HIV infection.

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