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 with gastroesophageal reflux disease is being taught by a nurse about managing the illness. Which of the following recommendations should the nurse include in the teaching?

• A. Limit fluid intake not related to meals.
• B. Chew on mint leaves to relieve indigestion.
• C. Avoid eating within 3 hours of bedtime.
• D. Season foods with black pepper.

Correct answer: C

Rationale: The correct recommendation for managing gastroesophageal reflux disease is to avoid eating within 3 hours of bedtime. This helps prevent acid reflux by allowing food to digest before lying down. Choices A, B, and D are incorrect. Limiting fluid intake not related to meals is not a standard recommendation for managing GERD. Chewing on mint leaves may worsen symptoms as mint can relax the lower esophageal sphincter, allowing stomach acid to flow back up. Seasoning foods with black pepper does not specifically help manage GERD.

3. Which factor has been shown to increase the risk of development of atherosclerosis?

• A. Menopause
• B. Age older than 35
• C. Increased levels of arachidonic acid
• D. Elevated HDL cholesterol

Correct answer: A

Rationale: The correct answer is A: Menopause. Menopause is associated with an increased risk of atherosclerosis due to hormonal changes that affect lipid profiles and vascular health. Conversely, B: Age older than 35 is not necessarily a risk factor for atherosclerosis on its own, though atherosclerosis risk does generally increase with age. C: Increased levels of arachidonic acid is not specifically linked to atherosclerosis; it's a fatty acid that can be both beneficial and harmful to health depending on its metabolic pathway. D: Elevated HDL cholesterol is actually beneficial rather than harmful because HDL cholesterol is known as 'good' cholesterol that helps to reduce the risk of heart disease and atherosclerosis.

4. A vegan patient might be at risk for deficiency in which of the following nutrients?

• A. Vitamin B12
• B. Vitamin C
• C. Carbohydrates
• D. Fiber

Correct answer: A

Rationale: The correct answer is Vitamin B12. Vitamin B12 is primarily found in animal products, so individuals following a vegan diet are at risk of deficiency as they do not consume these sources. Vitamin C, Carbohydrates, and Fiber are not specifically at risk for deficiency in vegan diets as they can be obtained from plant-based sources.

5. 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.

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