Nursing Elites

1. A nurse in a prenatal clinic is educating a client about expected changes during pregnancy. The nurse should instruct the client about which change during pregnancy is related to the slowing of the gastrointestinal tract?

• A. Diarrhea
• B. Constipation
• C. Decreased absorption of iron
• D. Decreased absorption of calcium

Correct answer: B

Rationale: During pregnancy, the hormonal changes can lead to the slowing down of the gastrointestinal tract, causing constipation. This occurs due to increased progesterone levels, which relax smooth muscles, including those in the intestines, leading to slower bowel movements. Diarrhea is not typically associated with the slowing of the gastrointestinal tract during pregnancy. While there may be changes in the absorption of nutrients like iron and calcium, they are not directly related to the slowing of the gastrointestinal tract.

2. Which of the following has the greatest effect on an increase in body weight?

• A. Carbohydrate intake
• B. Protein intake
• C. Fat intake
• D. Total kilocalories

Correct answer: D

Rationale: Total kilocalories have the greatest effect on body weight as they represent the overall energy intake from all macronutrients combined. While the consumption of specific macronutrients like carbohydrates, proteins, and fats can affect weight management, the total calories consumed play the most significant role in determining body weight. Therefore, choices A, B, and C are incorrect as they focus on individual macronutrients rather than the overall energy balance provided by total kilocalories.

3. What is one of the best nutritional actions a caregiver can take to help a patient with Alzheimer's disease maintain appropriate body weight?

• A. Thicken liquids to prevent choking
• B. Supervise food planning and mealtimes
• C. Assist the person in completing a grocery checklist
• D. Feed the person their meals and snacks

Correct answer: B

Rationale: The correct answer is B, 'Supervise food planning and mealtimes'. This action ensures the patient with Alzheimer's disease maintains an appropriate diet and body weight, thus reducing the risk of malnutrition. While choices A, 'Thicken liquids to prevent choking', C, 'Assist the person in completing a grocery checklist', and D, 'Feed the person their meals and snacks', might be beneficial in certain circumstances, they do not directly contribute to the maintenance of appropriate body weight as effectively as supervising food planning and mealtimes does.

4. Why are blood glucose levels high in type 1 diabetes?

• A. The urinary excretion of glucose is impaired
• B. The lean body mass is metabolized to produce glucose via gluconeogenesis
• C. The absorption of glucose from the gastrointestinal tract is more efficient
• D. There is insufficient insulin to facilitate the transport of glucose into the cells

Correct answer: D

Rationale: In type 1 diabetes, the body's immune system destroys the beta cells in the pancreas that produce insulin. This leads to an insufficient amount of insulin, which is required to facilitate the transport of glucose into the cells. Consequently, blood glucose levels remain high. The other options are incorrect. Option A is incorrect because urinary excretion of glucose does not directly contribute to blood glucose levels. Option B is incorrect because, while gluconeogenesis does produce glucose, it is not the cause of high glucose levels in type 1 diabetes. Option C is incorrect because absorption efficiency of glucose from the gastrointestinal tract does not affect the amount of insulin available to transport glucose into cells.

5. A client is receiving education from a nurse regarding the dietary changes needed for weight loss. Which of the following actions should the nurse perform first?

• A. Educate the client about daily caloric requirements.
• B. Determine the client’s daily caloric intake.
• C. Provide the client with meal planning information.
• D. Show the client how to identify the fat content of packaged foods.

Correct answer: B

Rationale: The correct answer is to determine the client’s daily caloric intake first. This step is crucial in understanding the client's current dietary habits and establishing a baseline for creating an effective weight loss plan. Educating the client about daily caloric requirements (Choice A) can only be done effectively after knowing the client's current intake. Providing meal planning information (Choice C) and teaching the client how to identify fat content in foods (Choice D) come after determining the baseline caloric intake to tailor the plan accordingly.

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