Nursing Elites

1. Among people who are ill, significant weight loss may be masked by?

• A. dehydration
• B. a large tumor
• C. drug therapy
• D. fluid retention

Correct answer: D

Rationale: Fluid retention can mask weight loss in ill individuals as the retained fluid adds to body weight, making it difficult to detect true fat or muscle loss. Dehydration (Choice A) would actually lead to weight loss rather than masking it. While a large tumor (Choice B) could contribute to weight loss, it would not mask the weight loss itself. Drug therapy (Choice C) may cause side effects, including weight changes, but it is unlikely to mask significant weight loss in the same way that fluid retention does.

2. A nurse is providing discharge teaching for a client who has acute pancreatitis and has a prescription for fat-soluble vitamin supplements. The nurse should instruct the client to take a supplement for which of the following?

• A. Vitamin A
• B. Vitamin B1
• C. Vitamin C
• D. Vitamin B12

Correct answer: A

Rationale: In acute pancreatitis, malabsorption of fat-soluble vitamins can occur due to pancreatic enzyme insufficiency. Vitamin A is a fat-soluble vitamin that may need supplementation in this case. Vitamin B1 (thiamine), Vitamin C, and Vitamin B12 are water-soluble vitamins and are not typically affected by pancreatic enzyme insufficiency in acute pancreatitis. Therefore, the correct supplement for the client with acute pancreatitis is Vitamin A.

3. What is the most significant dietary influence on the development of dental caries?

• A. Carbohydrates
• B. Vitamins
• C. Minerals
• D. Fats

Correct answer: A

Rationale: The correct answer is A: Carbohydrates. Carbohydrates, especially fermentable sugars, are the most significant dietary factor in the development of dental caries. When these sugars are consumed, they can be fermented by bacteria in the mouth, leading to the production of acids. These acids lower the pH in the mouth, creating an acidic environment that promotes demineralization of the tooth enamel, ultimately causing dental caries. Choices B, C, and D are incorrect because while vitamins and minerals are important for overall health, they do not have the same direct impact on the development of dental caries as fermentable carbohydrates do. Fats, on the other hand, do not play a significant role in the development of dental caries.

4. Which nutrients might people who follow a vegan diet be deficient in?

• A. Vitamin B12
• B. Vitamin C
• C. Vitamins A and D
• D. Calcium

Correct answer: C

Rationale: People who adhere to a vegan diet might indeed be deficient in vitamins A and D, which are primarily found in animal-derived foods. While vitamin B12 and calcium can also be lacking in a vegan diet, these were not choices given that would correctly answer the question. Vitamin C, on the other hand, is widely available in numerous plant-based foods, making it less likely for vegans to be deficient in it. Therefore, the correct answer is 'Vitamins A and D'. It's important to note that deficiencies can be avoided through careful meal planning or supplementation.

5. What is the most likely complication for a client receiving TPN who suddenly develops tremors, dizziness, and diaphoresis?

• A. Fluid volume overload
• B. Sepsis
• C. Hyperglycemia
• D. Hypoglycemia

Correct answer: D

Rationale: The correct answer is D, Hypoglycemia. When a client receiving TPN suddenly develops tremors, dizziness, and diaphoresis, it is indicative of hypoglycemia. TPN provides a high concentration of glucose, and if it is abruptly stopped or the infusion rate is reduced, it can lead to hypoglycemia. Choices A, B, and C are incorrect as they do not directly correlate with the symptoms described in the scenario. Fluid volume overload typically presents with edema and hypertension, sepsis with fever and increased heart rate, and hyperglycemia with polyuria, polydipsia, and blurred vision.

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