Nursing Elites

1. Dietary fiber has been recommended for its possible benefits in reducing heart disease by lowering blood cholesterol. How is fiber thought to play its role in lowering blood cholesterol?

• A. Insoluble fiber binds with cholesterol in the large intestine and is excreted in feces
• B. Viscous fiber binds with bile in the intestine and is excreted in feces
• C. Soluble fiber binds with cholesterol in the blood and is excreted by the liver
• D. Insoluble fiber converts to bile in the large intestine and binds with cholesterol

Correct answer: B

Rationale: The correct answer is B. Viscous (soluble) fiber binds with bile acids in the intestine, which are then excreted. The liver must use cholesterol to make more bile acids, thereby lowering blood cholesterol levels. Choice A is incorrect as insoluble fiber does not bind with cholesterol in the large intestine. Choice C is incorrect as soluble fiber does not directly bind with cholesterol in the blood. Choice D is incorrect as insoluble fiber does not convert to bile in the large intestine to bind with cholesterol.

2. High blood pressure is defined as systolic and diastolic measurements greater than or equal to:

• A. 140 mm Hg and 90 mm Hg, respectively
• B. 150 mm Hg and 80 mm Hg, respectively
• C. 160 mm Hg and 110 mm Hg, respectively
• D. 180 mm Hg and 120 mm Hg, respectively

Correct answer: A

Rationale: High blood pressure, or hypertension, is typically defined as having a systolic pressure of 140 mm Hg or higher and/or a diastolic pressure of 90 mm Hg or higher. Therefore, the correct answer is A. Choice B is incorrect because it suggests a higher systolic measurement than the standard definition. Choice C is incorrect as it provides an even higher systolic measurement and a much higher diastolic measurement. Choice D is also incorrect as it suggests extremely elevated blood pressure values, well above the typical definition of hypertension.

3. A client is prescribed a 1500-calorie diet. Thirty percent of the calories are to be derived from fat. How many grams of fat should the nurse tell the client to consume per day? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

• A. 21
• B. 49
• C. 60
• D. 50

Correct answer: D

Rationale: To calculate the grams of fat, first, determine the calories from fat by multiplying the total calorie intake (1500 calories) by the percentage of calories from fat (30%), which equals 450 calories from fat. Since 1 gram of fat is equivalent to 9 calories, divide the total calories from fat (450) by the calories in 1 gram of fat (9) to get the answer in grams, which is 50. Therefore, the client should consume 50 grams of fat per day. Choice A (21), Choice B (49), and Choice C (60) are incorrect as they do not reflect the accurate calculation based on the given information.

4. Which of the following methods is the best method for determining nasogastric tube placement in the stomach?

• A. X-ray
• B. Observation of gastric aspirate
• C. Testing of pH of gastric aspirate
• D. Placement of external end of tube under water

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.

5. _____ neutralizes stomach acid in the small intestine:

• A. saliva
• B. gastric mucus
• C. bicarbonate ions
• D. enzymes

Correct answer: C

Rationale: The correct answer is C: bicarbonate ions. Bicarbonate ions, secreted by the pancreas, neutralize the acidic chyme entering the small intestine from the stomach, creating a more suitable environment for digestive enzymes. Saliva (choice A) helps in the initial breakdown of food in the mouth, not in neutralizing stomach acid. Gastric mucus (choice B) protects the stomach lining from the acidic environment but does not neutralize the acid in the small intestine. Enzymes (choice D) facilitate chemical reactions in digestion but do not neutralize stomach acid.

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