Nursing Elites

1. You are teaching your clients the difference between Type I (IDDM) and Type II (NDDM) diabetes. Which of the following statements is true?

• A. Both types of diabetes mellitus clients are prone to developing ketosis.
• B. Type II (NIDDM) is more common and preventable compared to Type I (IDDM) diabetes, which is genetic.
• C. Type I (IIDM) is characterized by fasting hyperglycemia.
• D. Type II (NIDDM) is characterized by abnormal immune response.

Correct answer: D

Rationale: The correct answer is D. Type II diabetes (NIDDM) is characterized by insulin resistance and a relative lack of insulin. It is not primarily characterized by an abnormal immune response. Option A is incorrect because only Type I diabetes clients are prone to developing ketosis due to a lack of insulin. Option B is incorrect because while Type II diabetes is more common and often preventable through lifestyle changes, it is not solely genetic. Option C is incorrect because Type I diabetes, not Type II, is characterized by fasting hyperglycemia due to an absolute lack of insulin production.

2. A client receiving total parenteral nutrition (TPN is awaiting the next container. What fluid should the nurse infuse in the interim?

• A. Dextrose 5% in water
• B. 0.9% sodium chloride
• C. Dextrose 10% in water
• D. Lactated Ringer's solution

Correct answer: B

Rationale: The correct answer is 0.9% sodium chloride. When a client receiving TPN is awaiting the next container, infusing 0.9% sodium chloride is the appropriate choice to maintain fluid and electrolyte balance. Dextrose solutions are not recommended as they do not provide sufficient nutrition. Lactated Ringer's solution contains electrolytes but lacks essential nutrients found in TPN, making it an inadequate choice during the delay in TPN delivery.

3. Dietary fiber has been recommended for its possible benefits in reducing heart disease by lowering blood cholesterol. How is fiber thought to play its role in lowering blood cholesterol?

• A. Insoluble fiber binds with cholesterol in the large intestine and is excreted in feces
• B. Viscous fiber binds with bile in the intestine and is excreted in feces
• C. Soluble fiber binds with cholesterol in the blood and is excreted by the liver
• D. Insoluble fiber converts to bile in the large intestine and binds with cholesterol

Correct answer: B

Rationale: The correct answer is B. Viscous (soluble) fiber binds with bile acids in the intestine, which are then excreted. The liver must use cholesterol to make more bile acids, thereby lowering blood cholesterol levels. Choice A is incorrect as insoluble fiber does not bind with cholesterol in the large intestine. Choice C is incorrect as soluble fiber does not directly bind with cholesterol in the blood. Choice D is incorrect as insoluble fiber does not convert to bile in the large intestine to bind with cholesterol.

4. During times of staff and financial shortage, which method is the best and most effective?

• A. Functional Method
• B. Primary Nursing
• C. Team Nursing
• D. Modular Method

Correct answer: D

Rationale: During times of staff and financial shortage, the Modular Method is considered the best and most effective. This method allows for flexibility and adaptability in assigning tasks and responsibilities, making it easier to cope with limited resources. Functional Method (Choice A) focuses on the division of labor based on each staff member's skills, which may not be the most efficient during shortages. Primary Nursing (Choice B) and Team Nursing (Choice C) may require a more significant number of staff, making them less suitable during shortages.

5. A nurse is instructing the mother of a toddler who has iron-deficiency anemia to increase iron in the child's diet in addition to the prescribed iron supplement. Which of the following foods should the nurse recommend?

• A. Skim milk
• B. Bananas
• C. Tuna fish
• D. Cucumbers

Correct answer: C

Rationale: Tuna fish is a good source of iron and would be beneficial for a toddler with iron-deficiency anemia. Skim milk, bananas, and cucumbers are not significant sources of iron and would not help in increasing the iron levels in the child's diet. Skim milk, in particular, can inhibit iron absorption due to its calcium content, which is important for the nurse to educate the mother about.

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