Nursing Elites

1. 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.

2. What laboratory value would be considered a high-risk measure for coronary heart disease assessment?

• A. triglycerides > 150 mg/dL
• B. BMI > 31
• C. LDL cholesterol < 128 mg/dL
• D. blood pressure of 128/82 mmHg

Correct answer: B

Rationale: The correct answer is B: BMI > 31. A BMI over 31 is considered a high-risk factor for coronary heart disease as it indicates obesity, which is strongly linked to cardiovascular issues. Triglycerides > 150 mg/dL (choice A) can contribute to heart disease risk but are not as specific as BMI in assessing overall risk. LDL cholesterol < 128 mg/dL (choice C) is actually a desirable level, indicating lower risk. A blood pressure of 128/82 mmHg (choice D) is within normal range and not a high-risk measure specifically for coronary heart disease.

3. Each of the following accurately describes aspects of the dietary reference intakes (DRIs) published by the Food and Nutrition Board of the Institute of Medicine (IOM) except one. Which one is the exception?

• A. The DRIs replace the older recommended daily allowances
• B. Current DRIs attempt to estimate required nutrients to improve long-term health
• C. DRIs specifically address individuals whose requirements are affected by a disease state
• D. The DRIs attempt to establish maximum safe levels of tolerance for nutrients

Correct answer: C

Rationale: The correct answer is C. DRIs are intended for the general population and do not specifically address disease states, which are managed with different clinical guidelines. Choice A is correct as DRIs have replaced the older recommended daily allowances. Choice B is correct as current DRIs aim to estimate the required nutrients for long-term health. Choice D is correct as DRIs also attempt to establish maximum safe levels of tolerance for nutrients.

4. Each nonnutritive sweetener can be recommended to patients with phenylketonuria, except one. Which one is the exception?

• A. Cyclamate
• B. Acesulfame-K
• C. Saccharin
• D. Aspartame

Correct answer: D

Rationale: The correct answer is D, Aspartame. Aspartame contains phenylalanine, which is contraindicated for individuals with phenylketonuria (PKU), a genetic disorder that impairs phenylalanine metabolism. Therefore, patients with PKU should avoid aspartame. Choices A, B, and C (Cyclamate, Acesulfame-K, Saccharin) are considered safe for individuals with PKU as they do not contain phenylalanine and can be recommended as alternatives to sugar for these patients.

5. A nurse is developing a plan of care for a client who has anorexia nervosa. Which of the following actions should the nurse include in the plan?

• A. Encourage the client to participate in developing a system of rewards.
• B. Arrange for someone to remain with the client for 30 minutes after meals.
• C. Offer the client a selection of beverages at each meal.
• D. Inform the client that a weight gain of 2.3 kg per week is expected.

Correct answer: A

Rationale: Encouraging the client to participate in developing a system of rewards is an essential part of the plan of care for a client with anorexia nervosa. This action can help motivate and engage the client in their treatment plan, promoting a sense of achievement and progress. Choice B, arranging for someone to remain with the client for 30 minutes after meals, may not address the underlying issues related to anorexia nervosa and could potentially disrupt the client's independence. Choice C, offering a selection of beverages at each meal, is not directly related to addressing the client's condition of anorexia nervosa. Choice D, informing the client about an expected weight gain, could increase anxiety and may not be appropriate without considering the client's individual progress and readiness.

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