Nursing Elites

1. Signs of malnutrition can appear when:

• A. nutrient reserves are depleted.
• B. nutrient intake exceeds daily needs.
• C. energy intake is restricted.
• D. caloric expenditure increases.

Correct answer: A

Rationale: The correct answer is A: 'nutrient reserves are depleted.' Signs of malnutrition manifest when the body's reserves of essential nutrients are exhausted and can no longer sustain health. Choice B is incorrect because excessive nutrient intake exceeding daily needs does not lead to malnutrition but may cause other health issues. Choice C is incorrect as restricting energy intake may lead to weight loss but not necessarily malnutrition. Choice D is also incorrect as increasing caloric expenditure does not directly cause malnutrition.

2. What is the muscle layer on the outside of the intestinal wall called?

• A. serosa
• B. mucosa
• C. submucosa
• D. muscularis mucosae

Correct answer: A

Rationale: The correct answer is A: serosa. The serosa is the outermost layer of the intestinal wall, providing a protective covering. Choice B, mucosa, is the innermost layer responsible for absorption. Choice C, submucosa, lies beneath the mucosa and contains blood vessels and nerves. Choice D, muscularis mucosae, is a smooth muscle layer located within the mucosa, helping to create folds in the intestinal lining to increase surface area for absorption.

3. After ingested food is mixed and churned with gastric secretions, the resulting semifluid mass is called:

• A. a bolus.
• B. chyme.
• C. rennin.
• D. glycogen.

Correct answer: B

Rationale: The correct answer is B: chyme. Chyme is the partially digested food that forms a semifluid mass after mixing with gastric juices. A is incorrect because a bolus refers to a rounded mass of food ready to be swallowed. C, rennin, is an enzyme involved in the digestion of milk proteins and not the term for the semifluid mass after food mixing with gastric secretions. D, glycogen, is a form of stored glucose in the body and is not the term used to describe the partially digested food mass in the stomach.

4. Which of the following enzymes is found in pancreatic secretions?

• A. Rennin
• B. Pepsin
• C. Chymotrypsin
• D. Casein

Correct answer: C

Rationale: Chymotrypsin is an enzyme found in pancreatic secretions that plays a role in protein digestion. Rennin is primarily found in the stomach and is involved in milk digestion. Pepsin is also a stomach enzyme that aids in protein breakdown. Casein is a protein found in milk, not an enzyme involved in pancreatic secretions. Therefore, the correct answer is Chymotrypsin.

5. Which condition may benefit from branched chain amino acids (leucine, isoleucine, and valine)?

• A. cancer-related malnutrition
• B. marasmus
• C. cardiovascular disease
• D. severe depression

Correct answer: A

Rationale: Branched chain amino acids, such as leucine, isoleucine, and valine, are essential in preventing muscle breakdown. Therefore, they may be particularly important for a patient with cancer-related malnutrition, where maintaining muscle mass is crucial. Marasmus is a severe form of malnutrition characterized by energy deficiency, not specifically related to cancer. Cardiovascular disease and severe depression do not have a direct correlation with the need for branched chain amino acids to prevent muscle breakdown.

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