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. Reducing the amount of trans fat in the diet is an effective method of decreasing the risk of CHD. Which food is most likely a source of trans fat?

• A. hot dogs
• B. whole milk
• C. fatty fish
• D. potato chips

Correct answer: D

Rationale: The correct answer is D: potato chips. Potato chips, especially when fried in hydrogenated oils, are a common source of trans fats, which are linked to an increased risk of coronary heart disease (CHD). Hot dogs (choice A) can also contain trans fats if made with processed meats and added fats. Whole milk (choice B) and fatty fish (choice C) do not typically contain trans fats, making them less likely sources compared to potato chips.

3. Each statement is true of vitamin K, except one. Which is the exception?

• A. Vitamin K is produced in the gut.
• B. Vitamin K functions as a catalyst for the synthesis of blood-clotting factors.
• C. Vitamin K maintains prothrombin levels.
• D. Vitamin K absorption increases with high levels of vitamin E supplementation.

Correct answer: D

Rationale: The correct answer is D. Vitamin K absorption decreases with high levels of vitamin E supplementation because in larger amounts, vitamin E acts as an anticoagulant. Vitamin K is not produced in the gut but can be obtained from food sources or supplements. Vitamin K is essential for the synthesis of blood-clotting factors and is crucial in maintaining prothrombin levels, which is vital for proper blood clotting. The incorrect choice, D, is misleading as high levels of vitamin E supplementation hinder vitamin K absorption due to its anticoagulant properties. Dental hygienists should be aware of the importance of vitamin K in blood clotting, especially when treating patients who are on anticoagulant medications for conditions like stroke prevention.

4. A nurse is planning care for a toddler who has burns over 50% total body surface area. Which of the following actions should the nurse include in the plan of care?

• A. Administer enteral feedings
• B. Limit intake of vitamin C
• C. Limit dietary protein
• D. Administer insulin prior to meals

Correct answer: A

Rationale: Administering enteral feedings is crucial for ensuring adequate nutrition and supporting healing in toddlers with extensive burns. Burns over 50% total body surface area can lead to increased metabolic demands, making it essential to provide nutrition through enteral feedings to meet the child's needs for healing and recovery. Limiting intake of vitamin C or dietary protein would be detrimental in this scenario as the child requires increased amounts of nutrients to support healing. Administering insulin prior to meals is not indicated in this case as the priority is to provide adequate nutrition to promote healing.

5. A nurse is caring for a client who has a new prescription for a low-sodium diet. The client's family has requested to bring in some of the client's favorite foods. Which of the following food items should the nurse tell the family members to omit?

• A. Boiled rice
• B. Flat bread
• C. Broiled fish fillet
• D. Pickled vegetables

Correct answer: D

Rationale: The correct answer is 'Pickled vegetables.' Pickled vegetables are high in sodium due to the pickling process, making them unsuitable for a low-sodium diet. Boiled rice, flat bread, and broiled fish fillet are generally lower in sodium compared to pickled vegetables and can be included in a low-sodium diet. Therefore, the nurse should advise the family to omit pickled vegetables to adhere to the client's dietary restrictions.

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