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 metabolic disease is characterized by poor healing, severe forms of periodontal disease, necrosis, xerostomia, and candidiasis?

• A. Hypopituitarism
• B. Diabetes mellitus
• C. Hyperthyroidism
• D. Renal disease

Correct answer: B

Rationale: Diabetes mellitus is the correct answer. It is associated with poor wound healing, severe periodontal disease, tissue necrosis, dry mouth (xerostomia), and an increased susceptibility to oral infections like candidiasis. Hypopituitarism, hyperthyroidism, and renal disease are not typically linked to the specific oral manifestations described in the question.

3. A nurse is developing a program about strategies to prevent foodborne illnesses for a community group. The nurse should plan to include which of the following recommendations? (Select one that does not apply).

• A. Keep cold food temperatures below 4.4�C (40�F).
• B. Reheat leftovers before eating.
• C. Wash raw vegetables thoroughly in clean water.
• D. Keep cooked foods at 48.9�C (120�F).

Correct answer: D

Rationale: The correct answer is to keep cooked foods at 48.9�C (120�F). This temperature is too low to keep cooked foods safe from bacterial growth. The ideal temperature to keep cooked foods safe is above 60�C (140�F). Choices A, B, and C are all important strategies to prevent foodborne illnesses. Keeping cold food temperatures below 4.4�C (40�F) helps prevent bacterial growth, reheating leftovers before eating kills any bacteria that may have grown during storage, and washing raw vegetables thoroughly in clean water helps remove dirt and bacteria.

4. Select all that apply. Which of the following are true about protein digestion?

• A. the end products of protein digestion are amino acids
• B. protein/polypeptides are digested in the large intestine by trypsin
• C. A, D
• D. protein/polypeptides are digested in the stomach by pepsin

Correct answer: C

Rationale: Protein digestion begins in the stomach with the enzyme pepsin, which breaks down proteins into smaller polypeptides. The end products of protein digestion are amino acids.

5. What is the most significant dietary influence on the development of dental caries?

• A. Carbohydrates
• B. Vitamins
• C. Minerals
• D. Fats

Correct answer: A

Rationale: The correct answer is A: Carbohydrates. Carbohydrates, especially fermentable sugars, are the most significant dietary factor in the development of dental caries. When these sugars are consumed, they can be fermented by bacteria in the mouth, leading to the production of acids. These acids lower the pH in the mouth, creating an acidic environment that promotes demineralization of the tooth enamel, ultimately causing dental caries. Choices B, C, and D are incorrect because while vitamins and minerals are important for overall health, they do not have the same direct impact on the development of dental caries as fermentable carbohydrates do. Fats, on the other hand, do not play a significant role in the development of dental caries.

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