Nursing Elites

1. A client with gastroesophageal reflux disease is being taught by a nurse about managing the illness. Which of the following recommendations should the nurse include in the teaching?

• A. Limit fluid intake not related to meals.
• B. Chew on mint leaves to relieve indigestion.
• C. Avoid eating within 3 hours of bedtime.
• D. Season foods with black pepper.

Correct answer: C

Rationale: The correct recommendation for managing gastroesophageal reflux disease is to avoid eating within 3 hours of bedtime. This helps prevent acid reflux by allowing food to digest before lying down. Choices A, B, and D are incorrect. Limiting fluid intake not related to meals is not a standard recommendation for managing GERD. Chewing on mint leaves may worsen symptoms as mint can relax the lower esophageal sphincter, allowing stomach acid to flow back up. Seasoning foods with black pepper does not specifically help manage GERD.

2. What are the potential consequences of damage to the stomach?

• A. Reduced digestion of carbohydrates
• B. Inability to produce or secrete bile
• C. Inability to produce or secrete gastric acid
• D. Increased ability to produce or secrete intrinsic factor

Correct answer: C

Rationale: Damage to the stomach can lead to a reduced ability to produce gastric acid (Choice C) and intrinsic factor, the latter of which is crucial for vitamin B12 absorption (Choice D). That's why these two choices are correct. The stomach doesn't play a direct role in the digestion of carbohydrates (Choice A) as this process primarily occurs in the small intestine with the help of pancreatic enzymes. Similarly, bile is produced by the liver and stored in the gallbladder, not the stomach, hence stomach damage wouldn't lead to an inability to produce or secrete bile (Choice B).

3. Each of the following foods has cariostatic properties, with one exception. Which food is the exception?

• A. Eggs
• B. Instant oatmeal
• C. Cheese
• D. Seafood

Correct answer: B

Rationale: Cariostatic foods are those that contribute to the prevention of tooth decay. Eggs, cheese, and seafood are all cariostatic foods, as they can aid in protecting against tooth decay. On the contrary, instant oatmeal does not possess these cariostatic properties. Due to its processed nature, it is more fermentable and cariogenic, which means it can encourage cavity formation. Although it is not directly harmful to the teeth, it does not provide the same defensive benefits against tooth decay as the other choices do. Therefore, 'Instant oatmeal' is the exception among these foods and is the correct answer.

4. A client who practices Islam and is currently observing dietary restrictions for the month of Ramadan. Which of the following interventions should the nurse include in the plan of care?

• A. Remove pork products from the dietary plan
• B. Facilitate fasting during daylight hours
• C. Serve meat and dairy items together
• D. Provide a low-carb diet on Fridays

Correct answer: B

Rationale: During Ramadan, individuals fast from dawn to sunset. Facilitating fasting during daylight hours respects the dietary practices of clients observing Ramadan. Choice A is incorrect as the dietary restriction during Ramadan involves abstaining from all food and drink during daylight hours, not just beef products. Choice C is incorrect as Muslims generally do not consume meat and dairy together due to religious dietary laws. Choice D is incorrect as providing a low-carb diet on Fridays does not specifically align with the dietary restrictions observed during Ramadan.

5. Dina, 17 years old, asks you how a tubal ligation prevents pregnancy. Which would be the best answer?

• A. Prostaglandins released from the cut fallopian tubes can kill sperm
• B. Sperm cannot enter the uterus because the cervical entrance is blocked
• C. Sperm can no longer reach the ova, because the fallopian tubes are blocked
• D. The ovary no longer releases ova as there is nowhere for them to go

Correct answer: C

Rationale: The correct answer is C: 'Sperm can no longer reach the ova because the fallopian tubes are blocked.' Tubal ligation works by blocking the fallopian tubes, preventing sperm from reaching the egg for fertilization. Choice A is incorrect because prostaglandins are not released from the cut fallopian tubes to kill sperm. Choice B is incorrect as the cervical entrance being blocked does not relate to tubal ligation. Choice D is incorrect because tubal ligation does not affect the release of ova from the ovary.

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