Nursing Elites

1. Which dietary modification is most suitable for a client with type 2 diabetes who wants to improve glycemic control?

• A. Increase intake of saturated fats
• B. Decrease intake of refined carbohydrates
• C. Completely avoid all fruits
• D. Increase intake of sugary snacks

Correct answer: B

Rationale: Decreasing the intake of refined carbohydrates is the most effective dietary modification for a client with type 2 diabetes who aims to improve their glycemic control. Refined carbohydrates can cause sudden spikes in blood sugar levels, making diabetes management more difficult. Increasing the intake of saturated fats (Choice A) is not advisable as it can negatively impact heart health. Completely avoiding all fruits (Choice C) is unnecessary because most fruits have a low glycemic index and provide essential nutrients. Increasing the intake of sugary snacks (Choice D) will deteriorate glycemic control due to their high sugar content.

2. How would protein deficiency likely affect dental tissues?

• A. Decreased resistance to dental caries
• B. Increased tooth size
• C. Delayed tooth development
• D. Increased enamel mineralization

Correct answer: C

Rationale: Protein deficiency can lead to delayed tooth development as the body may not have enough resources to form teeth properly. This delay can make the teeth more susceptible to dental issues due to incomplete formation. Choices A, B, and D are incorrect. Decreased resistance to dental caries is more related to factors like poor oral hygiene and sugary diets, increased tooth size is not a common effect of protein deficiency on dental tissues, and increased enamel mineralization is not typically associated with protein deficiency.

3. Inadequate intake of vitamin A occurs in lower socioeconomic groups due to a lack of resources to purchase and consume vegetables and fruits.

• A. Both the statement and the reason are correct and related.
• B. Both the statement and the reason are correct but are not related.
• C. The statement is correct, but the reason is not correct.
• D. The statement is not correct, but the reason is correct.

Correct answer: A

Rationale: Both the statement and the reason are correct and related. Inadequate intake of vitamin A in lower socioeconomic groups is due to a lack of resources to purchase and consume vegetables and fruits. This is supported by the fact that the average intake in the United States meets the Recommended Dietary Allowance (RDA) for vitamin A intake, except in lower socioeconomic groups. These individuals often lack the financial means to buy, prepare, and eat a variety of fruits and vegetables, leading to deficiencies. It's important to note that because vitamin A can be stored in the liver, most adults have sufficient quantities to maintain health. Choices B, C, and D are incorrect because the statement and reason are both accurate and logically connected, as the lack of resources directly impacts the ability to obtain necessary sources of vitamin A.

4. Which nutrient deficiency produces microcytic anemia, fatigue, faulty digestion, blue sclerae, pale conjunctivae, and tachycardia?

• A. Zinc
• B. Iron
• C. Sodium
• D. Potassium

Correct answer: B

Rationale: A deficiency in iron can lead to various symptoms, such as microcytic anemia, fatigue, faulty digestion, blue sclerae, pale conjunctivae, and tachycardia. Iron-deficiency anemia may be caused by inadequate dietary intake; accelerated demand or losses; and inadequate absorption secondary to diarrhea, decreased acid secretions, or antacid therapy. Iron deficiency is frequently the result of postnatal feeding practices and has a serious impact on growth and mental and psychomotor development in infants and children. Choices A, C, and D are incorrect as zinc deficiency typically presents with symptoms like impaired wound healing, taste abnormalities, and hair loss; sodium deficiency can lead to symptoms such as muscle cramps, dizziness, and confusion; and potassium deficiency may cause muscle weakness, fatigue, and abnormal heart rhythms.

5. During the first 24 hours after the thermal injury, you should assess Sergio for:

• A. hypokalemia and hypernatremia
• B. hypokalemia and hyponatremia
• C. hyperkalemia and hyponatremia
• D. hyperkalemia and hypernatremia

Correct answer: D

Rationale: During the initial phase after a thermal injury, the major concern is the release of potassium due to cell damage, leading to hyperkalemia. Hypernatremia is not typically a primary concern in the immediate post-injury phase. Hyponatremia is less likely to occur initially after a burn injury. Therefore, the correct assessment for Sergio during the first 24 hours after the thermal injury would be hyperkalemia and hypernatremia.

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