Nursing Elites

1. A nurse is caring for a client who is to receive a mechanically altered diet. Which of the following client food choices necessitates intervention by the nurse?

• A. Scrambled eggs
• B. Cottage cheese
• C. Piece of wheat toast
• D. Sliced banana

Correct answer: D

Rationale: The correct answer is 'Sliced banana.' A mechanically altered diet is designed for clients who have difficulty chewing or swallowing. Sliced bananas, due to their texture and potential choking hazard for clients with swallowing difficulties, would necessitate intervention by the nurse. Scrambled eggs, cottage cheese, and a piece of wheat toast are softer and safer options for clients on a mechanically altered diet, making them appropriate choices.

2. What physiologic role does magnesium play in the body?

• A. Blood clotting, transmission of nerve impulses, muscle contraction and relaxation
• B. Calcium homeostasis, structural integrity of heart muscle
• C. No known metabolic function, caries-preventing properties
• D. ATP energy release; metabolism of fats, carbohydrates, proteins; regulates acid-base balance

Correct answer: B

Rationale: The correct answer is B. Magnesium plays an important role in maintaining calcium homeostasis and preventing skeletal abnormalities. It is involved in more than 300 enzymatic reactions, including energy metabolism, insulin activity, and glucose use. Magnesium is vital to the structural integrity of heart muscle and other muscles and nerves. While magnesium does play a role in blood clotting, nerve impulses, muscle contraction, relaxation, ATP energy release, and metabolism of fats, carbohydrates, proteins, the primary physiologic role of magnesium in the body is related to calcium homeostasis and maintaining the structural integrity of the heart muscle. Choice A is incorrect because it includes functions of magnesium, but they are not its primary physiologic role. Choice C is incorrect as magnesium has several known metabolic functions. Choice D is incorrect because although magnesium is involved in ATP energy release and metabolism, its primary role is related to calcium homeostasis and structural integrity of muscle.

3. The mentally ill person responds positively to the nurse who is warm and caring. This is a demonstration of the nurse’s role as:

• A. counselor
• B. mother surrogate
• C. therapist
• D. socializing agent

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

4. The ideal time to begin taking folate to prevent neural tube defects is:

• A. Before conception
• B. Once pregnancy begins
• C. At 6 weeks
• D. Upon completion of the first trimester

Correct answer: A

Rationale: Folate is crucial before conception to prevent neural tube defects. Neural tube development occurs early in pregnancy, often before a woman knows she is pregnant.

5. 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.

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