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. What instruction should a nurse include when teaching a client who has recently been prescribed a low-sodium diet?

• A. Avoid foods such as smoked meats and frozen dinners.
• B. Select foods with less than 4g of sodium as indicated on food labels.
• C. Use soy sauce for flavoring foods instead of table salt.
• D. Processed and prepared foods are typically low in sodium.

Correct answer: A

Rationale: The correct answer is A, which directs the client to avoid foods such as smoked meats and frozen dinners. These types of foods are typically high in sodium, making them unsuitable for a low-sodium diet. Option B is incorrect because foods with less than 4g of sodium might still be high in sodium for individuals on low-sodium diets. The daily recommended intake of sodium for a low-sodium diet is usually around 1.5g to 2g. Hence, 4g of sodium in a single food product can be excessive. Option C is incorrect as soy sauce, although a different source of flavor, is also high in sodium and should be used sparingly, if at all, in a low-sodium diet. Option D is incorrect because processed and prepared foods are usually not low in sodium. In fact, these foods often have high sodium content due to added salts and preservatives.

3. A nurse is planning care for a client who has ascites secondary to liver disease. Which of the following interventions should the nurse include in the plan of care?

• A. Reduce complex carbohydrates to 30% of total calories.
• B. Restrict protein intake to less than 0.8 g/kg/day.
• C. Decrease daily caloric intake by 20%.
• D. Limit sodium to 2000 mg or less per day.

Correct answer: D

Rationale: The correct answer is to limit sodium to 2000 mg or less per day. Ascites, which is the abnormal accumulation of fluid in the abdominal cavity, is commonly associated with liver disease. Limiting sodium intake helps manage fluid retention by reducing the fluid accumulation in the abdomen. Choices A, B, and C are incorrect because reducing complex carbohydrates, restricting protein intake, or decreasing caloric intake are not the primary interventions for managing ascites in liver disease.

4. Overweight and obesity often accompany conditions such as _____ that limit mobility or result in short stature, which can lead to feeding difficulties.

• A. Parkinson's disease
• B. muscular dystrophy
• C. Down syndrome
• D. multiple sclerosis

Correct answer: C

Rationale: The correct answer is C, Down syndrome. Down syndrome is often associated with short stature and limited mobility, which can contribute to feeding difficulties and obesity. Parkinson's disease (choice A) primarily affects motor function, but it is not typically associated with short stature. Muscular dystrophy (choice B) primarily impacts muscle strength and does not necessarily lead to short stature. Multiple sclerosis (choice D) is a neurological condition affecting the central nervous system and does not directly cause short stature or feeding difficulties as seen in Down syndrome.

5. Each statement is true of water-soluble vitamins, except one. Which is it?

• A. Act as coenzymes
• B. Deficiencies develop rapidly
• C. Daily intake is necessary
• D. Absorbed in the jejunum

Correct answer: B

Rationale: The correct answer is B. Water-soluble vitamins do not develop deficiencies rapidly because the body does not store them for long periods. They must be obtained through food constantly. Choice A is correct because water-soluble vitamins often act as coenzymes in various metabolic reactions. Choice C is correct as daily intake of water-soluble vitamins is necessary since they are not stored in the body. Choice D is incorrect as water-soluble vitamins are absorbed primarily in the small intestine, particularly in the duodenum and ileum, not the jejunum.

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