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. A condition that often progresses to become type 2 diabetes mellitus is:

• A. type 1 diabetes mellitus
• B. high blood pressure
• C. chronic pancreatitis
• D. impaired glucose tolerance

Correct answer: D

Rationale: Impaired glucose tolerance is a pre-diabetic state characterized by higher than normal blood sugar levels. It is often associated with insulin resistance and can progress to type 2 diabetes mellitus. Type 1 diabetes mellitus (Choice A) is an autoimmune condition where the body attacks insulin-producing cells, leading to a lack of insulin production. High blood pressure (Choice B) and chronic pancreatitis (Choice C) are not directly linked to the progression to type 2 diabetes mellitus.

3. What physiological role does phosphorus play in the body?

• A. Blood clotting, transmission of nerve impulses, muscle contraction, and relaxation
• B. Calcium homeostasis, structural integrity of heart muscle
• C. No known metabolic function, caries-preventing properties
• D. ATP energy release; metabolism of fats, carbohydrates, proteins; regulates acid-base balance

Correct answer: D

Rationale: The correct answer is D. Phosphorus plays a crucial role in ATP energy release, the metabolism of fats, carbohydrates, and proteins, and regulation of acid-base balance. Choices A, B, and C are incorrect. Phosphorus is not directly involved in blood clotting, transmission of nerve impulses, muscle contraction, or calcium homeostasis. It also has known metabolic functions and is not associated with caries prevention.

4. The purpose of chest percussion and vibration is to loosen secretions in the lungs. The difference between the procedures is:

• A. Percussion uses only one hand, while vibration uses both hands
• B. Percussion delivers cushioned blows to the chest with cupped palms, while vibration gently shakes secretions loose
• C. In both percussion and vibration, the hands are not on top of each other, and hand action is not in tune with the client's breath
• D. Percussion slaps the chest to loosen secretions, while vibration shakes the secretions along with the inhalation

Correct answer: D

Rationale: Chest percussion involves the use of rhythmic tapping to dislodge mucus from the lungs, facilitating its movement toward the larger airways where it can be expelled. This technique is particularly important in conditions where mucus retention is a significant risk factor for infection. The key difference between chest percussion and vibration is that percussion involves slapping the chest to loosen secretions, while vibration involves shaking the secretions along with the inhalation, aiding in moving the loosened secretions upwards for easier removal. Choices A, B, and C do not accurately describe the main difference between chest percussion and vibration, making them incorrect.

5. What is the desirable resting systolic blood pressure for adults?

• A. <130 mmHg>
• B. <105 mmHg>
• C. <120 mmHg>
• D. <140 mmHg>

Correct answer: C

Rationale: The desirable resting systolic blood pressure for adults is less than 120 mmHg. This blood pressure is associated with a lower risk of cardiovascular disease. Measurements higher than 120 mmHg (choices A and D) indicate elevated blood pressure, which can lead to hypertension and other health complications if not managed. A reading of less than 105 mmHg (choice B) could indicate low blood pressure, which also poses health risks such as dizziness and fainting.

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