Nursing Elites

1. In a patient with liver cirrhosis, weight gain due to fluid retention can mask the symptoms of what condition?

• A. Liver failure
• B. Gallbladder disease
• C. Heart failure
• D. Protein-Energy Malnutrition (PEM)

Correct answer: D

Rationale: In a patient with liver cirrhosis, weight gain due to fluid retention can mask Protein-Energy Malnutrition (PEM) symptoms. This can lead to an increase in weight, making it challenging to identify weight loss or muscle wasting associated with PEM. Therefore, option D is correct. Options A, B, and C are incorrect because fluid retention and weight gain related to liver cirrhosis do not necessarily hide the symptoms of liver failure, gallbladder disease, or heart failure.

2. Stimulates secretion of bicarbonate ions and digestive enzymes from the pancreas to the small intestine:

• A. pepsin
• B. salivary amylase
• C. CCK
• D. secretin

Correct answer: D

Rationale: Secretin stimulates the pancreas to release bicarbonate ions to neutralize stomach acid and digestive enzymes into the small intestine.

3. A client with nephropathy secondary to diabetes mellitus is receiving dietary teaching from a nurse and plans to make dietary adjustments. Which of the following instructions should the nurse include?

• A. Consume less than 45% of total calories from carbohydrates per day.
• B. Eat no more than 300 mg of cholesterol per day.
• C. Consume less than 0.8 g/kg of body weight of protein per day.
• D. Eat at least 45 g of fiber per day.

Correct answer: D

Rationale: For a client with nephropathy secondary to diabetes mellitus, increasing fiber intake is essential as it can help manage blood sugar levels and improve overall bowel health. Choice A is incorrect because carbohydrates should be controlled but not limited to less than 45% of total calories. Choice B is incorrect as the recommended daily cholesterol intake for individuals with diabetes is less than 200 mg. Choice C is incorrect as protein intake should be individualized based on the client's condition and should not be limited to less than 0.8 g/kg of body weight per day.

4. In which type of shock does the patient experience a mismatch of blood flow to the cells?

• A. Distributive
• B. Cardiogenic
• C. Hypovolemic
• D. Septic

Correct answer: A

Rationale: The correct answer is A: Distributive shock. Distributive shock is characterized by a widespread increase in vascular permeability leading to a relative hypovolemia and a mismatch of blood flow to the cells. Choice B, Cardiogenic shock, is due to the heart's inability to pump effectively. Choice C, Hypovolemic shock, results from a decrease in intravascular volume. Choice D, Septic shock, is caused by a systemic response to infection.

5. Can bacterial plaque metabolize sucrose, lactose, and fructose? Is fructose, also known as levulose and found naturally in honey, less cariogenic than sucrose and lactose?

• A. Yes, bacterial plaque can metabolize these sugars, but no, fructose is not less cariogenic.
• B. No, bacterial plaque cannot metabolize these sugars, and fructose is not less cariogenic.
• C. Yes, bacterial plaque can metabolize these sugars, but no, fructose is not less cariogenic.
• D. No, bacterial plaque cannot metabolize these sugars, but yes, fructose is less cariogenic.

Correct answer: A

Rationale: The first statement is correct as bacterial plaque can indeed metabolize sucrose, lactose, and fructose. However, the second statement is inaccurate. Fructose, despite being found naturally in honey and known also as levulose, is not less cariogenic than either sucrose or lactose. This means that its consumption does not result in fewer cavities or tooth decay. Therefore, the correct answer is that bacterial plaque can metabolize these sugars, but fructose is not less cariogenic. Choices B, C, and D are incorrect because they either wrongly assert that bacterial plaque cannot metabolize these sugars or wrongly claim that fructose is less cariogenic.

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