Nursing Elites

1. A common comorbidity in patients with Chronic Kidney Disease (CKD) is:

• A. Liver disease
• B. Malnutrition
• C. Acute renal failure
• D. Difficulty breathing

Correct answer: B

Rationale: Malnutrition is a common comorbidity in patients with Chronic Kidney Disease (CKD). This is mainly due to factors such as dietary restrictions, poor appetite, and the body's increased nutritional needs as it struggles to deal with the disease. Liver disease (Choice A) is not typically associated directly with CKD, although both conditions may coexist in some patients. Acute renal failure (Choice C) is not a comorbidity but a severe and potentially lethal progression of CKD. Difficulty breathing (Choice D) is not a comorbidity but can be a symptom of severe kidney disease or other underlying conditions. However, malnutrition is more commonly observed in CKD patients compared to difficulty breathing.

2. The nurse interprets the statement “Bow down before me! I am the holy mother of Christ! I am the blessed Virgin Mary!” as important in documenting in which of the following areas of mental status examination?

• A. Thought content
• B. Mood
• C. Affect
• D. Attitude

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

3. An advance directive known as a durable power of attorney involves appointing another person called a(n) _____ to act as the decision maker in the event of the patient's incapacitation.

• A. witness
• B. primary caregiver
• C. health care agent
• D. state proxy

Correct answer: C

Rationale: The correct answer is 'health care agent.' A health care agent is appointed through a durable power of attorney to make medical decisions on behalf of a patient who becomes incapacitated. The term 'witness' (choice A) is incorrect because a witness only observes the signing of the directive and does not make decisions. 'Primary caregiver' (choice B) is also incorrect as they may provide care but are not necessarily legally empowered to make decisions. 'State proxy' (choice D) is not commonly used in the context of advance directives or health care decision making, making it an incorrect choice.

4. How would protein deficiency likely affect dental tissues?

• A. Decreased resistance to dental caries
• B. Increased tooth size
• C. Delayed tooth development
• D. Increased enamel mineralization

Correct answer: C

Rationale: Protein deficiency can lead to delayed tooth development as the body may not have enough resources to form teeth properly. This delay can make the teeth more susceptible to dental issues due to incomplete formation. Choices A, B, and D are incorrect. Decreased resistance to dental caries is more related to factors like poor oral hygiene and sugary diets, increased tooth size is not a common effect of protein deficiency on dental tissues, and increased enamel mineralization is not typically associated with protein deficiency.

5. One of the most common factors that compromise the vitamin D status of older adults, particularly those living in assisted living communities is _____.

• A. decreased intake of fruits and vegetables
• B. lack of physical activity
• C. malabsorption due to atrophic gastritis
• D. lack of exposure to sunlight

Correct answer: D

Rationale: The correct answer is 'D: lack of exposure to sunlight.' Older adults, especially those in assisted living communities, are at risk of vitamin D deficiency due to spending most of their time indoors, which reduces their exposure to sunlight. Sunlight is essential for the body to produce vitamin D. Choices A, B, and C are less likely to be major factors in compromising vitamin D status. While a decreased intake of fruits and vegetables and lack of physical activity can impact overall health, they are not as directly related to vitamin D status. Malabsorption due to atrophic gastritis may affect the absorption of certain nutrients, but vitamin D synthesis primarily depends on sunlight exposure.

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