Nursing Elites

1. A nurse at a provider's office is providing teaching to a client who is taking chemotherapy and losing weight. Which of the following should the nurse recommend to increase calorie and protein intake? (Select one that does not apply.)

• A. Top yogurt with fruits.
• B. Add cream to soups.
• C. Use milk instead of water in recipes.
• D. Increase fluids during meals.

Correct answer: D

Rationale: The correct recommendation to increase calorie and protein intake for a client taking chemotherapy and losing weight is to add cream to soups (choice B), as it provides additional calories and proteins. Using milk instead of water in recipes (choice C) can also increase the calorie and protein content. Topping yogurt with fruits (choice A) can be a healthy choice but may not significantly increase calorie and protein intake. Increasing fluids during meals (choice D) may fill up the stomach, potentially reducing the intake of solid foods, which is not ideal when trying to increase calorie and protein consumption.

2. Which of the following converts starch to disaccharides, and this reaction occurs in the _____?

• A. pancreatic amylases, small intestine
• B. brush border enzymes, small intestine
• C. luminal enzymes, large intestine
• D. pancreatic amylases, pancreas

Correct answer: A

Rationale: The correct answer is A. Pancreatic amylases break down starch into disaccharides in the small intestine. This process occurs in the small intestine, not the large intestine or pancreas. Brush border enzymes act on disaccharides to break them down into monosaccharides, while luminal enzymes are not specifically involved in the conversion of starch to disaccharides.

3. Which dietary modification is most suitable for a client with type 2 diabetes who wants to improve glycemic control?

• A. Increase intake of saturated fats
• B. Decrease intake of refined carbohydrates
• C. Completely avoid all fruits
• D. Increase intake of sugary snacks

Correct answer: B

Rationale: Decreasing the intake of refined carbohydrates is the most effective dietary modification for a client with type 2 diabetes who aims to improve their glycemic control. Refined carbohydrates can cause sudden spikes in blood sugar levels, making diabetes management more difficult. Increasing the intake of saturated fats (Choice A) is not advisable as it can negatively impact heart health. Completely avoiding all fruits (Choice C) is unnecessary because most fruits have a low glycemic index and provide essential nutrients. Increasing the intake of sugary snacks (Choice D) will deteriorate glycemic control due to their high sugar content.

4. A client who is experiencing dumping syndrome following gastric surgery is receiving education from a nurse. Which of the following statements by the client indicates an understanding of the teaching?

• A. I should drink additional fluids with my meals.
• B. I should eat high-fiber snacks between meals.
• C. I should eat a protein source with each meal.
• D. I can have caffeinated beverages in small amounts.

Correct answer: C

Rationale: The correct answer is C. Eating a protein source with each meal can help manage dumping syndrome by slowing gastric emptying and reducing symptoms. This choice is the most appropriate as it directly addresses a key dietary recommendation for dumping syndrome. Choices A, B, and D are incorrect because drinking additional fluids with meals, eating high-fiber snacks between meals, and consuming caffeinated beverages can exacerbate dumping syndrome symptoms by increasing gastric emptying and worsening the condition.

5. In which type of shock does the patient experience a mismatch of blood flow to the cells?

• A. Distributive
• B. Cardiogenic
• C. Hypovolemic
• D. Septic

Correct answer: A

Rationale: The correct answer is A: Distributive shock. Distributive shock is characterized by a widespread increase in vascular permeability leading to a relative hypovolemia and a mismatch of blood flow to the cells. Choice B, Cardiogenic shock, is due to the heart's inability to pump effectively. Choice C, Hypovolemic shock, results from a decrease in intravascular volume. Choice D, Septic shock, is caused by a systemic response to infection.

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