Nursing Elites

1. When assessing older adult clients for malnutrition at an adult day care center, which risk factors should the nurse consider?

• A. Dental problems
• B. Depression
• C. Both A and B
• D. Ability to prepare meals

Correct answer: C

Rationale: The correct answer is C: Both A and B. Dental problems and depression are both significant risk factors for malnutrition in older adults. Dental problems can lead to difficulty in chewing and swallowing, resulting in reduced food intake. On the other hand, depression can cause changes in appetite and decreased interest in eating, which can also contribute to malnutrition. Although the ability to prepare meals is important, it is not specifically identified as a risk factor for malnutrition within the context of this question. Therefore, choices A and B are the most appropriate answers.

2. Each statement regarding the correlation between vitamin D and sun exposure is accurate, except one. Which is the exception?

• A. The body can produce sufficient amounts of vitamin D from sunlight.
• B. UV radiation can convert a precursor of vitamin D to vitamin D3 by penetrating uncovered skin.
• C. Sunscreen blocks the formation of vitamin D3.
• D. By the age of 70 years, the skin generally produces vitamin D at only half the level it did at the age of 20 years.

Correct answer: C

Rationale: While UV radiation can penetrate uncovered skin and convert a precursor of vitamin D to vitamin D3, sunscreen does block the formation of vitamin D3. Sunscreen is recommended by dermatologists to prevent sunburn and reduce the risk of skin cancer. The other choices are correct: the body can produce sufficient vitamin D from sunlight, UV radiation can convert a precursor of vitamin D to vitamin D3, and skin generally produces less vitamin D as a person ages.

3. The Acceptable Macronutrient Distribution Ranges state that half of your calories should come from protein.

• A. TRUE
• B. FALSE
• C.
• D.

Correct answer: B

Rationale: The statement is FALSE. The Acceptable Macronutrient Distribution Ranges recommend that 10-35% of daily calories come from protein, not half. The remaining calories should be derived from a combination of carbohydrates and fats to ensure a balanced diet. Choosing option A is incorrect because it misinterprets the recommended percentage for protein intake. Options C and D are left blank as they are not applicable to the question.

4. A healthcare professional is reviewing the lab findings of a client who has Clostridium Difficile. Which of the following findings should indicate to the healthcare professional that the client is experiencing Fluid Volume Deficit?

• A. Hct 53%
• B. Potassium 3.5
• C. Sodium 145
• D. HbA1c 5

Correct answer: A

Rationale: An elevated hematocrit level (Hct 53%) indicates hemoconcentration, a sign of fluid volume deficit. Hct measures the percentage of red blood cells in the blood and increases when there is a decrease in plasma volume, as seen in fluid volume deficit. Choices B, C, and D do not directly relate to fluid volume status. Potassium and sodium levels are more indicative of electrolyte imbalances, while HbA1c reflects average blood sugar levels over the past 2-3 months and is not specific to fluid volume status.

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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