Nursing Elites

1. Each statement is true of rickets, except one. Which is the exception?

• A. Rickets is being diagnosed more frequently in the United States.
• B. Rickets is caused by vitamin C deficiency.
• C. Tachetic deformities such as bow legs or knock-knees develop.
• D. A narrow and distorted chest occurs.

Correct answer: B

Rationale: Rickets is caused by vitamin D deficiency, not vitamin C deficiency. It usually occurs in children who are 1 to 3 years old. The name rickets came from the word 'wrikken,' meaning 'to bend or twist.' Common manifestations of rickets include tachetic deformities like bow legs or knock-knees, a narrow and distorted chest, and failure of the epiphyses of bones to develop normally, resulting in twisted and warped bones. While the diagnosis of rickets may be increasing in the United States, it is not caused by a lack of vitamin C.

2. Mang Carlos has been terminally ill for 5 years. He asked his wife to decide for him when he is no longer capable to do so. As a Nurse, You know that this is called:

• A. Last will and testament
• B. DNR
• C. Living will
• D. Durable Power of Attorney

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

3. Myxedema coma is a life-threatening complication of long-standing and untreated hypothyroidism with one of the following characteristics.

• A. Hyperglycemia
• B. Hypothermia
• C. Hyperthermia
• D. Hypoglycemia

Correct answer: A

Rationale: Myxedema coma is associated with hypothermia, not hyperthermia. Therefore, the correct characteristic of myxedema coma is hypothermia. This condition is a medical emergency that requires prompt recognition and intervention to prevent serious complications. The presence of hyperglycemia is not a defining characteristic of myxedema coma, making choice A the correct answer in this case. Hyperthermia and hypoglycemia are not typically seen in myxedema coma and are not consistent with the clinical presentation of this condition.

4. The nurse is working with a patient who recently had a stroke. The patient frequently chokes and coughs when eating and is having difficulty feeding herself. What is the best way to ensure adequate nutrition?

• A. to have an aide feed her at each meal
• B. to ask a family member to assist during meals
• C. to provide tube feedings for the patient
• D. to initiate TPN for the patient

Correct answer: C

Rationale: The best way to ensure adequate nutrition for a stroke patient who frequently chokes and coughs when eating and has difficulty feeding herself is to provide tube feedings. Tube feedings are a safe and effective method to deliver nutrition directly to the stomach or intestines, bypassing the swallowing mechanism, reducing the risk of aspiration. Having an aide feed her each meal (choice A) may not address the underlying issue of swallowing difficulty and aspiration risk. Asking a family member to be present at each meal (choice B) does not provide a definitive solution to the patient's nutritional needs. Placing the patient on total parenteral nutrition (TPN) (choice D) is a more invasive and typically reserved for patients who cannot tolerate enteral feedings or have non-functional gastrointestinal tracts.

5. Each statement accurately describes the physical effects of food on periodontal health, except one. Which is the exception?

• A. Supragingival plaque biofilm adhesion is influenced by frequent consumption of monosaccharides
• B. Supragingival plaque biofilm adhesion is influenced by frequent consumption of disaccharides
• C. Poor nutrition has an adverse effect on the periodontium
• D. Chewing soft, spongy foods stimulates salivary flow

Correct answer: D

Rationale: The correct answer is D. Chewing soft, spongy foods does not stimulate salivary flow; rather, firm, fibrous foods like fruits and vegetables do. Soft foods can stick to teeth, promoting plaque buildup. Choices A, B, and C are accurate: Supragingival plaque biofilm adhesion is influenced by both monosaccharides and disaccharides, while poor nutrition can indeed have adverse effects on the periodontium.

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