Nursing Elites

1. What is the initial major sign of acute renal failure?

• A. Oliguria
• B. Hematuria
• C. Proteinuria
• D. Glycosuria

Correct answer: A

Rationale: Oliguria, or reduced urine output, is often the initial major sign of acute renal failure. This reduction in urine output indicates that the kidneys are not functioning properly. Hematuria (blood in urine), proteinuria (presence of protein in urine), and glycosuria (presence of glucose in urine) are not typically the initial major signs of acute renal failure. While they may be present in certain conditions, oliguria is the most common and critical indicator of acute renal failure.

2. Which cells in the islet of the pancreas are responsible for synthesizing insulin?

• A. Alpha cells
• B. Beta cells
• C. Gamma cells
• D. Delta cells

Correct answer: B

Rationale: Beta cells in the islets of Langerhans in the pancreas are responsible for the production and secretion of insulin, which is crucial for regulating blood glucose levels. Alpha cells, on the other hand, produce glucagon, a hormone that raises blood glucose levels. Gamma cells and Delta cells do not exist in the islets of Langerhans; therefore, they are incorrect choices.

3. What stimulates bile secretion from the liver to the small intestine?

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

Correct answer: C

Rationale: Cholecystokinin (CCK) is the hormone that stimulates the release of bile from the gallbladder into the small intestine, aiding in fat digestion. Pepsin is an enzyme in the stomach that breaks down proteins into smaller peptides, not involved in bile secretion. Salivary Amylase is an enzyme in saliva that initiates starch digestion in the mouth, not related to bile secretion. Secretin is a hormone that regulates the release of gastric juice in the stomach and triggers the pancreas to neutralize stomach acid in the small intestine, but it does not stimulate bile secretion.

4. Is the loss of teeth or supporting periodontium often associated with poor food selection and limited chewing ability, and do the patients' masticatory efficiency and biting force decline with each tooth lost?

• A. Both statements are true
• B. Both statements are false
• C. The first statement is true; the second is false
• D. The first statement is false; the second is true

Correct answer: A

Rationale: Both statements are indeed true. The loss of teeth or supporting periodontium frequently leads to poor food selection and limited chewing ability, as these conditions can make certain foods difficult to consume. Additionally, a patient's masticatory efficiency and biting force do decline with each tooth lost, as there are fewer teeth to distribute the force of the bite. Choices B, C, and D are incorrect because they suggest that one or both of these statements are false, which is not the case.

5. Each statement is true of swallowing and processing food, except one. Which is the exception?

• A. The swallowing reflex moves a bolus into the esophagus
• B. A bolus is a mass of food
• C. The bolus is transported to the stomach by osmosis and gravity
• D. The bolus penetrates the diaphragm through the esophageal hiatus

Correct answer: C

Rationale: The correct answer is C. The bolus is not transported to the stomach by osmosis and gravity, but by peristalsis. Peristalsis is the involuntary constriction and relaxation of muscles to push the bolus through the digestive system. Choices A, B, and D are correct statements. A bolus is indeed a mass of food, the swallowing reflex does move the bolus into the esophagus, and the bolus does not penetrate the diaphragm through the esophageal hiatus; instead, it enters the stomach through the lower esophageal sphincter.

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