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. By the age of three, which age-appropriate food skill can a child typically perform?

• A. Using utensils and a napkin
• B. Spearing food with a fork
• C. Measuring liquids
• D. Displaying proper table manners

Correct answer: B

Rationale: By the age of three, a child typically develops the motor skills needed to spear food with a fork. This is a critical milestone in self-feeding as it shows progress in fine motor coordination. Choice 'A' is incorrect because using utensils and a napkin properly is a skill that may take longer to develop and refine. Choice 'C' is not correct as measuring liquids requires a higher level of motor skills and understanding of quantities that a three-year-old child might not possess. Choice 'D' is also incorrect as the proper display of table manners is a complex skill that is typically learned over a longer period and involves social and cultural norms.

3. According to the DASH Eating Plan, Carmen's daily sodium intake should not exceed how many milligrams to ensure the plan's effectiveness?

• A. 1000 milligrams
• B. 2500 milligrams
• C. 3000 milligrams
• D. 1500 milligrams

Correct answer: D

Rationale: The DASH Eating Plan is designed to lower blood pressure and is most effective when daily sodium intake is limited to 1500 milligrams or less. Therefore, choice D is the correct answer. Choices A (1000 milligrams), B (2500 milligrams), and C (3000 milligrams) are incorrect because they either fall below or exceed the recommended daily sodium intake for the DASH Eating Plan.

4. For a patient with celiac disease, which dietary modification is necessary?

• A. Increase protein intake
• B. Avoid gluten
• C. Increase dairy intake
• D. Avoid lactose

Correct answer: B

Rationale: The correct answer is B: Avoid gluten. Patients with celiac disease have an immune reaction to gluten, a protein found in wheat, barley, and rye. Therefore, it is crucial for individuals with celiac disease to avoid gluten-containing products. Increasing protein intake (Choice A) is not specifically necessary for celiac disease management. Increasing dairy intake (Choice C) is unrelated to the dietary requirements of individuals with celiac disease. Avoiding lactose (Choice D) is relevant for individuals with lactose intolerance, not celiac disease. Therefore, the only necessary modification for a patient with celiac disease is to avoid gluten.

5. A nurse is developing a plan of care for a client who has anorexia nervosa. Which of the following actions should the nurse include in the plan?

• A. Encourage the client to participate in developing a system of rewards.
• B. Arrange for someone to remain with the client for 30 minutes after meals.
• C. Offer the client a selection of beverages at each meal.
• D. Inform the client that a weight gain of 2.3 kg per week is expected.

Correct answer: A

Rationale: Encouraging the client to participate in developing a system of rewards is an essential part of the plan of care for a client with anorexia nervosa. This action can help motivate and engage the client in their treatment plan, promoting a sense of achievement and progress. Choice B, arranging for someone to remain with the client for 30 minutes after meals, may not address the underlying issues related to anorexia nervosa and could potentially disrupt the client's independence. Choice C, offering a selection of beverages at each meal, is not directly related to addressing the client's condition of anorexia nervosa. Choice D, informing the client about an expected weight gain, could increase anxiety and may not be appropriate without considering the client's individual progress and readiness.

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