Nursing Elites

1. In PEM, which condition is characterized by symptoms such as muscle weakness, hanging skin, delayed tooth eruption, and changes in saliva?

• A. Marasmus
• B. Kwashiorkor
• C. Anemia
• D. Noma

Correct answer: A

Rationale: The correct answer is Marasmus. Marasmus is a severe form of protein-energy malnutrition (PEM) that leads to muscle wasting, hanging skin, delayed growth, and changes in saliva. These symptoms are commonly seen in vulnerable populations such as children, homeless individuals, older adults, and substance abusers. Kwashiorkor, on the other hand, is characterized by edema, a distended belly, and skin lesions. Anemia is a condition characterized by a low red blood cell count, leading to fatigue and weakness. Noma is a severe infection affecting the face, particularly the mouth and jaw area.

2. A client has a small-bore jejunostomy and is receiving a continuous tube feeding with a high-viscosity formula. Which of the following actions should the nurse take to prevent the tubing from clogging?

• A. Replace the bag and tubing every 24 hours
• B. Flush the tubing with 10 mL water every 6 hours
• C. Administer the feeding by gravity drip
• D. Heat the formula prior to infusion

Correct answer: B

Rationale: To prevent clogging when using high-viscosity formulas in a small-bore jejunostomy, the nurse should flush the tubing with 10 mL of water every 6 hours. This action helps maintain tube patency and prevent blockages. Replacing the bag and tubing every 24 hours (Choice A) is unnecessary and does not specifically address preventing clogging. Administering the feeding by gravity drip (Choice C) or heating the formula prior to infusion (Choice D) are not effective interventions for preventing tubing clogging.

3. Which of the following foods should be avoided by patients experiencing xerostomia, except one? Which is the exception?

• A. Saltines
• B. Salsa
• C. Alcohol
• D. Dill pickles

Correct answer: D

Rationale: The correct answer is Dill pickles. Unlike the other choices, which can exacerbate xerostomia due to their dry or irritating nature, dill pickles, being tart and sour, can actually help stimulate saliva flow, which is beneficial for patients with xerostomia. Saltines, salsa, and alcohol are all known to contribute to dry mouth and should generally be avoided by individuals experiencing xerostomia.

4. Each statement regarding the correlation between vitamin D and sun exposure is accurate, except one. Which is the exception?

• A. The body can produce sufficient amounts of vitamin D from sunlight.
• B. UV radiation can convert a precursor of vitamin D to vitamin D3 by penetrating uncovered skin.
• C. Sunscreen blocks the formation of vitamin D3.
• D. By the age of 70 years, the skin generally produces vitamin D at only half the level it did at the age of 20 years.

Correct answer: C

Rationale: While UV radiation can penetrate uncovered skin and convert a precursor of vitamin D to vitamin D3, sunscreen does block the formation of vitamin D3. Sunscreen is recommended by dermatologists to prevent sunburn and reduce the risk of skin cancer. The other choices are correct: the body can produce sufficient vitamin D from sunlight, UV radiation can convert a precursor of vitamin D to vitamin D3, and skin generally produces less vitamin D as a person ages.

5. Maternal malnutrition at a critical period of development may have lifelong effects on an individual's pattern of genetic expression and on the tendency to develop obesity, which is a concept known as _____.

• A. genetic determination
• B. metabolic tolerance
• C. chromosomal influence
• D. fetal programming

Correct answer: D

Rationale: Fetal programming refers to the concept that maternal nutrition during critical periods of development can have long-term effects on an individual's health and risk of diseases like obesity.

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