Nursing Elites

1. One of the following statements is true with regards to the care of clients with depression:

• A. Only mentally ill persons commit suicide
• B. All depressed clients are considered potentially suicidal
• C. Most suicidal person gives no warning
• D. The chance of suicide lessens as depression lessens

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

2. A client with gastroesophageal reflux disease is being taught by a nurse about managing the illness. Which of the following recommendations should the nurse include in the teaching?

• A. Limit fluid intake not related to meals.
• B. Chew on mint leaves to relieve indigestion.
• C. Avoid eating within 3 hours of bedtime.
• D. Season foods with black pepper.

Correct answer: C

Rationale: The correct recommendation for managing gastroesophageal reflux disease is to avoid eating within 3 hours of bedtime. This helps prevent acid reflux by allowing food to digest before lying down. Choices A, B, and D are incorrect. Limiting fluid intake not related to meals is not a standard recommendation for managing GERD. Chewing on mint leaves may worsen symptoms as mint can relax the lower esophageal sphincter, allowing stomach acid to flow back up. Seasoning foods with black pepper does not specifically help manage GERD.

3. 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.

4. Which of the following statements are correct?

• A. Lipids are transported in the blood as lipoproteins, which are clusters of lipids associated with proteins.
• B. In type II diabetes, the pancreas produces insulin, but cells are resistant to this signal.
• C. The glycemic index classifies foods based on their potential to raise blood glucose levels.
• D. All of the above

Correct answer: D

Rationale: Option A is correct because lipoproteins indeed transport lipids in the blood. They are complexes of lipids and proteins that transport water-insoluble lipids through the blood. Option B is correct as it accurately describes the condition of type II diabetes where the pancreas can produce insulin, but the cells are resistant to its signal, causing an ineffective regulation of blood sugar. Option C is also correct because the glycemic index is indeed a classification system for foods based on their potential to raise blood glucose levels. High glycemic index foods raise blood glucose levels faster than low glycemic index foods. Hence, all the statements are correct, making option D the correct answer.

5. Patients maintained using peritoneal dialysis may gain weight because:

• A. their appetite is increased
• B. physical activity is limited
• C. they absorb glucose from the dialysate
• D. they absorb amino acids from the dialysate

Correct answer: C

Rationale: Glucose from the peritoneal dialysis solution can be absorbed into the bloodstream, leading to weight gain if not balanced with diet and activity.

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