Nursing Elites

1. A nurse is caring for a client following an appendectomy. The nurse verifies the postoperative prescription which reads, 'Discontinue NPO status; advance diet as tolerated.' Which of the following are appropriate for the nurse to offer the client? (SATA)

• A. Wheat toast
• B. Applesauce
• C. Applesauce, Chicken broth
• D. Chicken broth

Correct answer: C

Rationale: The correct answer is C: Applesauce and chicken broth. After an appendectomy, patients are typically started on a clear liquid diet before advancing to more solid foods. Applesauce and chicken broth are part of a low-residue diet that is easily digestible and gentle on the digestive system, making them suitable choices for a client following surgery. Wheat toast may be too heavy and fibrous initially, while other solid foods should be introduced gradually to prevent gastrointestinal upset.

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. How is the equalization of solute concentration of intracellular fluids (ICFs) and extracellular fluids (ECFs accomplished?

• A. Semipermeable membranes.
• B. Hydration.
• C. Osmotic pressure.
• D. Perspiration.

Correct answer: C

Rationale: The correct answer is C, osmotic pressure. Osmotic pressure within the body equalizes the solute concentration of ICFs and ECFs by shifting small amounts of water in the direction of higher concentration solute. Semipermeable membranes separate one fluid compartment from another and do not directly equalize solute concentrations. Hydration and perspiration are important elements of fluid balance but do not directly achieve the equalization of solute concentrations between ICFs and ECFs, which is primarily regulated by osmotic pressure.

4. Integrated management for childhood illness is the universal protocol of care endorsed by WHO and is used by different countries worldwide, including the Philippines. In any case that the nurse classifies the child and categorizes the signs and symptoms in the PINK category, you know that this means:

• A. Urgent referral
• B. Antibiotic Management
• C. Home treatment
• D. Outpatient treatment facility is needed

Correct answer: B

Rationale: When a child is classified under the PINK category in the Integrated Management of Childhood Illness (IMCI) guidelines, it signifies the need for antibiotic management. This category indicates severe signs and symptoms requiring immediate antibiotic treatment to address the underlying infection. Choices A, C, and D are incorrect because the PINK category specifically calls for urgent antibiotic management rather than urgent referral, home treatment, or outpatient treatment facility.

5. What describes a criterion used to diagnose diabetes?

• A. a plasma glucose concentration of 100 mg/dL or higher after a fast of at least 12 hours
• B. a casual blood sample of 200 mg/dL or higher in a person with classic symptoms
• C. a plasma glucose concentration measured two hours after a 200-gram glucose load is 400 mg/dL or higher
• D. a HbA1C higher than 5 percent

Correct answer: B

Rationale: A casual blood sample of 200 mg/dL or higher in a person with classic symptoms is a diagnostic criterion for diabetes. This choice aligns with the typical clinical presentation of diabetes and is a key diagnostic indicator. Choices A, C, and D do not accurately reflect the established criteria for diagnosing diabetes, making them incorrect. Choice A pertains to a fasting plasma glucose level, Choice C involves a glucose challenge test, and Choice D refers to HbA1C levels, which are used for monitoring blood sugar control over time, not for diagnosing diabetes.

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