Nursing Elites

1. A nurse is providing teaching to a client with gastroesophageal reflux. Which of the following statements by the client indicates a need for further teaching?

• A. I should elevate the head of my bed while sleeping.
• B. I drink no more than 4 cups of coffee a day.
• C. I take my time when I am eating.
• D. I avoid foods and drinks made with chocolate.

Correct answer: B

Rationale: The correct answer is B: 'I drink no more than 4 cups of coffee a day.' Excessive coffee consumption can aggravate gastroesophageal reflux due to its acidic nature. Choices A, C, and D are all appropriate self-care measures for managing gastroesophageal reflux. Elevating the head of the bed while sleeping helps prevent acid reflux, eating slowly can reduce reflux episodes, and avoiding trigger foods like chocolate can help alleviate symptoms.

2. Which organ produces and secretes bicarbonate ions and insulin?

• A. Stomach
• B. Pancreas
• C. Large intestine
• D. Small intestine

Correct answer: B

Rationale: The pancreas is the correct answer because it performs two vital functions: producing bicarbonate ions to neutralize stomach acid in the small intestine and secreting insulin to regulate blood glucose levels. The stomach is incorrect because its primary function is to break down and digest food, not produce bicarbonate ions or insulin. The large and small intestines are also incorrect because their primary functions are to absorb nutrients and water from food, rather than producing bicarbonate ions or insulin.

3. A breastfeeding mother complains that she missed her son's last two feedings and now her breasts have become full, hard, and uncomfortable. This condition is known as _____.

• A. mastitis
• B. engorgement
• C. letdown
• D. galactorrhea

Correct answer: B

Rationale: Engorgement occurs when the breasts become overly full, leading to discomfort and sometimes difficulty with latching. It can be relieved by feeding or expressing milk. Mastitis, choice A, is characterized by breast inflammation usually caused by an infection. Letdown, choice C, refers to the release of milk from the breast. Galactorrhea, choice D, is the spontaneous flow of milk from the breast unassociated with childbirth or nursing.

4. A nurse is planning a menu for a client with a folic acid deficiency anemia. Which food should the nurse recommend that is high in folate?

• A. 4 slices of roast beef
• B. ½ cup of asparagus
• C. 1 cup part-skim mozzarella cheese
• D. ¼ cup of olives

Correct answer: B

Rationale: The correct answer is B: ½ cup of asparagus. Asparagus is high in folate, making it a suitable recommendation for clients with folic acid deficiency anemia. Folate is essential in the production of red blood cells, which is crucial in managing anemia. Choices A, C, and D do not contain as much folate as asparagus and are not the best options for addressing a folic acid deficiency anemia.

5. 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.

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