Nursing Elites

1. Which types of diabetes are characterized by the body's cells becoming resistant to insulin? (Select all that apply)

• A. Gestational diabetes
• B. Type II diabetes
• C. Type I diabetes
• D. Both A and B

Correct answer: D

Rationale: In both gestational diabetes and Type II diabetes, the body's cells become resistant to insulin, leading to elevated blood glucose levels. Insulin resistance in these types of diabetes prevents glucose from entering the cells, causing it to accumulate in the bloodstream. On the other hand, Type I diabetes is characterized by the body's inability to produce insulin because the immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas. Therefore, the correct answer is both A and B. Choice C, Type I diabetes, is not characterized by insulin resistance but rather by the body's inability to produce insulin. Therefore, it is incorrect. Choice D, Both A and B, includes the correct options of gestational diabetes and Type II diabetes, making it the correct answer.

2. To follow a healthy diet, a person should be sure that:

• A. 20-35% of the total carbs eaten should be made up of fiber
• B. 45-65% of the total carbs eaten should be made up of fiber
• C. 45-65% of the total fiber eaten should be made up of soluble fiber
• D. 45-65% of the total calories eaten should be made up of carbs

Correct answer: D

Rationale: The Acceptable Macronutrient Distribution Range (AMDR) suggests that 45-65% of total daily calories should come from carbohydrates.

3. A nurse is initiating continuous enteral feedings for a client who has a new gastrostomy tube. Which of the following actions should the nurse take?

• A. Measure the client’s gastric residual every 12 hours.
• B. Obtain the client’s electrolyte levels every 4 hours.
• C. Keep the client’s head elevated at 15° during feedings.
• D. Flush the client’s tube with 30 mL of water every 4 hours.

Correct answer: D

Rationale: Flushing the client’s tube with 30 mL of water every 4 hours is essential to maintain tube patency and prevent blockages. This action helps ensure the continuous flow of enteral feedings without obstruction. Measuring the client’s gastric residual every 12 hours (Choice A) is important but not the priority when initiating enteral feedings. Obtaining the client’s electrolyte levels every 4 hours (Choice B) is unnecessary and not directly related to tube feeding initiation. Keeping the client’s head elevated at 15° during feedings (Choice C) is a good practice to prevent aspiration, but tube flushing is more crucial to prevent tube occlusion.

4. Of the following neurotransmitters, which demonstrates inhibitory action, helps control mood and sleep, and inhibits pain pathways?

• A. Serotonin
• B. Enkephalin
• C. Norepinephrine
• D. Acetylcholine

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

5. The nurse is caring for a client taking warfarin. Which meal brought in by the client's family is a priority to remove before the client eats it?

• A. Oriental cabbage salad with chicken
• B. Beef enchilada, rice, and beans
• C. Ham and cheese sandwich
• D. Macaroni salad and grapefruit slices

Correct answer: C

Rationale: The correct answer is C. Ham is high in vitamin K, which can interfere with warfarin. Vitamin K can decrease the effectiveness of warfarin, an anticoagulant medication. Choices A, B, and D do not contain high levels of vitamin K and are less likely to interfere with the client's warfarin therapy.

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