Nursing Elites

1. Which client is most likely to need regular injections of vitamin B12?

• A. The client with malabsorption syndrome.
• B. The client following a vegan eating pattern.
• C. The client whose stomach does not produce intrinsic factors.
• D. The client with alcoholism.

Correct answer: C

Rationale: The correct answer is C. The client whose stomach does not produce intrinsic factors is most likely to need regular injections of vitamin B12. Intrinsic factor is essential for the absorption of vitamin B12. Without intrinsic factor, the client cannot absorb vitamin B12 from food, necessitating the need for regular injections. Choices A, B, and D do not directly impact the production of intrinsic factors in the stomach, so they are less likely to result in the need for vitamin B12 injections.

2. 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.

3. A nurse is providing teaching to an obese client who has gestational diabetes and is at 25 weeks of gestation. Which of the following statements made by the client indicates a need for further teaching?

• A. This does not mean that my baby will have this disease.
• B. This means that I will have diabetes for the rest of my life.
• C. If I feel dizzy, I should drink six ounces of a non-diet soda.
• D. Being obese might be one reason why I developed diabetes.

Correct answer: B

Rationale: The statement 'This means that I will have diabetes for the rest of my life' indicates a need for further teaching. Gestational diabetes often resolves after pregnancy, although it does indicate a higher risk for developing type 2 diabetes in the future. The other choices are correct or provide appropriate information: A) Understanding that gestational diabetes does not mean the baby will have the disease is accurate. C) Advising to drink non-diet soda if feeling dizzy is incorrect and potentially harmful due to the sugar content. D) Recognizing that obesity can be a risk factor for developing diabetes is a valid statement.

4. When assessing Richard for chest percussion or chest vibration and postural drainage, Mario would focus on the following EXCEPT:

• A. Amount of food and fluid taken during the last meal before treatment
• B. Respiratory rate, breath sounds, and location of congestion
• C. Teaching the client's relatives to perform the procedure
• D. Doctor's order regarding position restrictions and client's tolerance for lying flat

Correct answer: B

Rationale: The correct answer is B because when assessing Richard for chest percussion or chest vibration and postural drainage, Mario would focus on various aspects such as the amount of food and fluid taken before treatment to prevent complications during the procedure, teaching the client's relatives to perform the procedure correctly, and following the doctor's orders regarding position restrictions and the client's tolerance for lying flat. Respiratory rate, breath sounds, and location of congestion would be assessed during the procedure itself, not as part of the pre-assessment.

5. Select all that apply. Characteristics of the 2 main types of essential fatty acids discussed in class include:

• A. they must be supplied by the diet
• B. they can be produced by a process called dehydrogenation
• C. they are anti-inflammatory
• D. they are all polyunsaturated fatty acids

Correct answer: A

Rationale: The correct answer is A: 'they must be supplied by the diet.' Essential fatty acids, like omega-3 and omega-6, cannot be produced by the body and must be obtained through the diet. They are polyunsaturated fatty acids, playing vital roles in inflammation and cell membrane structure. Choice B is incorrect because essential fatty acids cannot be produced by dehydrogenation, a process of removing hydrogen. Choice C is incorrect as not all essential fatty acids are anti-inflammatory; some have pro-inflammatory roles. Choice D is incorrect because not all essential fatty acids are polyunsaturated; omega-9, for example, is a monounsaturated essential fatty acid.

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