Nursing Elites

1. During the acute phase of a burn, the priority nursing intervention in caring for this client is:

• A. Prevention of infection
• B. Pain management
• C. Prevention of bleeding
• D. Fluid resuscitation

Correct answer: D

Rationale: During the acute phase of a burn, fluid resuscitation is the priority nursing intervention. This phase is characterized by fluid loss and the risk of hypovolemic shock. Administering fluids is crucial to maintain perfusion and prevent complications such as organ failure. While prevention of infection, pain management, and prevention of bleeding are important aspects of burn care, fluid resuscitation takes precedence in the acute phase to stabilize the client's condition and prevent further damage.

2. Which nutrient has the highest satiety value?

• A. Complex carbohydrates
• B. High-quality protein
• C. Low-quality protein
• D. Fat

Correct answer: D

Rationale: Fat has the highest satiety value among the listed nutrients. It slows down digestion, stays in the stomach longer, and provides a sustained release of energy, leading to increased feelings of fullness and satisfaction. Complex carbohydrates can also contribute to satiety, but fat generally has a stronger effect. High-quality protein is important for satiety as well, but it is generally not as filling as fat. Low-quality protein does not have as significant satiating effects as high-quality protein or fat.

3. In PEM, which condition is characterized by symptoms such as muscle weakness, hanging skin, delayed tooth eruption, and changes in saliva?

• A. Marasmus
• B. Kwashiorkor
• C. Anemia
• D. Noma

Correct answer: A

Rationale: The correct answer is Marasmus. Marasmus is a severe form of protein-energy malnutrition (PEM) that leads to muscle wasting, hanging skin, delayed growth, and changes in saliva. These symptoms are commonly seen in vulnerable populations such as children, homeless individuals, older adults, and substance abusers. Kwashiorkor, on the other hand, is characterized by edema, a distended belly, and skin lesions. Anemia is a condition characterized by a low red blood cell count, leading to fatigue and weakness. Noma is a severe infection affecting the face, particularly the mouth and jaw area.

4. What is the digestive action of lipase?

• A. It breaks down carbohydrates
• B. It breaks down proteins
• C. It breaks down lipids
• D. It aids in fat digestion

Correct answer: C

Rationale: Lipase is an enzyme that specifically breaks down lipids (fats) during the process of digestion, converting them into fatty acids and glycerol. This is why option C is the correct answer. Although option D is partially correct, it's less specific than option C. Lipase does not break down carbohydrates or proteins, so options A and B are incorrect.

5. What laboratory value would be considered a high-risk measure for coronary heart disease assessment?

• A. triglycerides > 150 mg/dL
• B. BMI > 31
• C. LDL cholesterol < 128 mg/dL
• D. blood pressure of 128/82 mmHg

Correct answer: B

Rationale: The correct answer is B: BMI > 31. A BMI over 31 is considered a high-risk factor for coronary heart disease as it indicates obesity, which is strongly linked to cardiovascular issues. Triglycerides > 150 mg/dL (choice A) can contribute to heart disease risk but are not as specific as BMI in assessing overall risk. LDL cholesterol < 128 mg/dL (choice C) is actually a desirable level, indicating lower risk. A blood pressure of 128/82 mmHg (choice D) is within normal range and not a high-risk measure specifically for coronary heart disease.

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