Nursing Elites

1. How can a diet high in fiber content benefit an individual?

• A. aid in weight loss.
• B. reduce diabetic ketoacidosis.
• C. lower cholesterol.
• D. reduce the need for folate.

Correct answer: C

Rationale: A diet high in fiber content can help lower cholesterol levels by reducing the absorption of cholesterol in the bloodstream. Fiber-rich foods, like grains, apples, potatoes, and beans, can aid in this process. While fiber can aid in weight loss by promoting a feeling of fullness and aiding digestion, it is not primarily for fast weight loss. Fiber does not directly reduce the risk of diabetic ketoacidosis, which is more related to managing blood sugar levels through insulin therapy and dietary control. Folate is a B vitamin that is essential for various bodily functions and is not influenced by fiber intake. Therefore, the correct answer is to lower cholesterol, as fiber plays a significant role in this benefit.

2. A client goes to the Emergency Department with acute respiratory distress and the following arterial blood gases (ABGs): pH 7.35, PCO2 40 mmHg, PO2 63 mmHg, HCO3 23, and oxygenation saturation (SaO2) 93%. Which of the following represents the best analysis of the etiology of these ABGs?

• A. tuberculosis (TB)
• B. pneumonia
• C. pleural effusion
• D. hypoxia

Correct answer: D

Rationale: A combined low PO2 and low SaO2 indicate hypoxia. The pH, PCO2, and HCO3 are normal. ABGs are not necessarily altered in TB or pleural effusion. In pneumonia, the PO2 and PCO2 might be low due to hypoxia stimulating hyperventilation, but the given ABG values specifically point to hypoxia as the primary issue.

3. The client asked about the role of leptin in the body. Which response should the nurse provide?

• A. It increases food intake in clients, thereby promoting obesity.
• B. It assists in the regulation of steroids.
• C. It increases the total fat mass of people who are obese.
• D. It might decrease the total fat mass in the bodies of people who are obese.

Correct answer: D

Rationale: Leptin is a protein hormone expressed in fat cells that regulates fat cell percentage in the body. It is associated with increased energy expenditure and decreased food intake through hypothalamic control. In obese individuals, there may be insensitivity or resistance to leptin's effects. Leptin influences other hormones like insulin and genetic factors related to fat regulation. Therefore, the correct response is that leptin might decrease total fat mass in obese individuals as it is involved in energy balance and fat regulation. Choices A, B, and C are incorrect because leptin does not increase food intake or promote obesity; it does not assist in the regulation of steroids, and it does not increase total fat mass in people who are obese.

4. The client is wheezing and struggling to breathe. Which of the inhaled medications is indicated at this time?

• A. Fluticasone (Flovent)
• B. Salmeterol (Serevent)
• C. Theophylline (Theodur)
• D. Albuterol (Atrovent)

Correct answer: D

Rationale: The correct answer is Albuterol (Atrovent) because it is a rapid-acting bronchodilator, essential for a client experiencing wheezing and difficulty breathing. Albuterol acts quickly, dilating the airways and providing immediate relief in cases of respiratory distress. Fluticasone (Flovent) and Salmeterol (Serevent) are maintenance medications for long-term asthma control, not suitable for acute situations described. Theophylline (Theodur) is a bronchodilator but with a slower onset compared to Albuterol, making it less appropriate for a client in immediate distress.

5. For a client with suspected appendicitis, in which quadrant should the nurse expect to find abdominal tenderness?

• A. upper right
• B. upper left
• C. lower right
• D. lower left

Correct answer: C

Rationale: The correct answer is C: lower right. Abdominal tenderness in the lower-right quadrant is a classic sign of appendicitis. The appendix is located in the lower right abdomen, so inflammation of the appendix typically causes tenderness in this specific area. Choices A, B, and D are incorrect because tenderness in the upper right, upper left, and lower left quadrants, respectively, is not typical in appendicitis cases. Therefore, the nurse should focus on assessing the lower right quadrant for tenderness when suspecting appendicitis.

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