Nursing Elites

1. A nurse is assessing a client who has malnutrition. Which of the following findings should the nurse expect?

• A. Increased vital capacity
• B. Dry skin
• C. Heat intolerance
• D. Decreased mental status

Correct answer: D

Rationale: Malnutrition can lead to a variety of physical and mental symptoms. One common manifestation of malnutrition is a decreased mental status, which includes confusion, lethargy, and cognitive impairment. Dry skin is a typical finding in malnutrition due to the lack of essential nutrients needed for skin health. Heat intolerance is not a direct consequence of malnutrition. While malnutrition can affect respiratory function, it typically leads to decreased vital capacity rather than increased. Therefore, the correct answer is decreased mental status.

2. The healthcare professional in the dialysis unit understands that patients may experience various complications during hemodialysis. What describes a common complication during hemodialysis?

• A. confusion
• B. profuse sweating
• C. hypertension
• D. leg cramps

Correct answer: D

Rationale: Leg cramps are a common complication during hemodialysis due to shifts in fluid and electrolyte levels that occur during the treatment. Confusion (choice A) is not a common complication specifically related to hemodialysis. Profuse sweating (choice B) is not typically associated with hemodialysis complications. Hypertension (choice C) might be a pre-existing condition in some patients but is not a direct common complication of hemodialysis.

3. Which factor contributes to the development of bone diseases in patients with Chronic Kidney Disease (CKD) due to retention?

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

Correct answer: D

Rationale: The correct answer is phosphorus. Retention of phosphorus in patients with Chronic Kidney Disease (CKD) contributes to the development of bone disorders, including osteodystrophy, because it disrupts the balance of calcium and phosphorus in the body. This imbalance leads to a variety of bone diseases. The other options - iron, sodium, and potassium - while important in the overall metabolic function, are not directly linked to the development of bone diseases in CKD patients due to retention.

4. A patient who reports stomach ulcers should avoid all the following foods, except one. Which is the exception?

• A. Proteins
• B. Caffeine
• C. Calcium
• D. Wheat

Correct answer: D

Rationale: Patients with stomach ulcers are advised to avoid foods that can increase stomach acid levels, such as caffeine, proteins, and calcium. Wheat, on the other hand, is generally well-tolerated by individuals with ulcers as it does not stimulate gastric secretions. Therefore, the correct answer is D. Choice A (Proteins), B (Caffeine), and C (Calcium) are not recommended for patients with stomach ulcers due to their potential to exacerbate symptoms.

5. Each statement is true of swallowing and processing food, except one. Which is the exception?

• A. The swallowing reflex moves a bolus into the esophagus
• B. A bolus is a mass of food
• C. The bolus is transported to the stomach by osmosis and gravity
• D. The bolus penetrates the diaphragm through the esophageal hiatus

Correct answer: C

Rationale: The correct answer is C. The bolus is not transported to the stomach by osmosis and gravity, but by peristalsis. Peristalsis is the involuntary constriction and relaxation of muscles to push the bolus through the digestive system. Choices A, B, and D are correct statements. A bolus is indeed a mass of food, the swallowing reflex does move the bolus into the esophagus, and the bolus does not penetrate the diaphragm through the esophageal hiatus; instead, it enters the stomach through the lower esophageal sphincter.

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