Nursing Elites

1. For a patient with celiac disease, which dietary modification is necessary?

• A. Increase protein intake
• B. Avoid gluten
• C. Increase dairy intake
• D. Avoid lactose

Correct answer: B

Rationale: The correct answer is B: Avoid gluten. Patients with celiac disease have an immune reaction to gluten, a protein found in wheat, barley, and rye. Therefore, it is crucial for individuals with celiac disease to avoid gluten-containing products. Increasing protein intake (Choice A) is not specifically necessary for celiac disease management. Increasing dairy intake (Choice C) is unrelated to the dietary requirements of individuals with celiac disease. Avoiding lactose (Choice D) is relevant for individuals with lactose intolerance, not celiac disease. Therefore, the only necessary modification for a patient with celiac disease is to avoid gluten.

2. Which of the following body processes is not dependent upon the presence of calcium in the body fluids?

• A. blood clotting
• B. transport of oxygen in the blood
• C. muscle contractions
• D. transmission of nerve impulses

Correct answer: B

Rationale: The transport of oxygen in the blood is carried out by hemoglobin, which does not require calcium; instead, calcium is essential for blood clotting, muscle contraction, and nerve transmission.

3. A caregiver is teaching a parent about recommended protein intake for a toddler. Which of the following food selections is equivalent to 1 oz of protein?

• A. 2 tbsp peanut butter
• B. ½ cup peas
• C. 1 slice of bread
• D. 1 scrambled egg

Correct answer: D

Rationale: One scrambled egg is equivalent to 1 oz of protein, making it a suitable choice for a toddler's diet. A ½ cup of peas (choice B) does not provide 1 oz of protein but is still a good source of protein. 2 tbsp of peanut butter (choice A) contains more than 1 oz of protein. 1 slice of bread (choice C) typically provides less protein than 1 oz.

4. 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).

5. For an incontinent elderly client who frequently wets his bed and develops redness and skin excoriation at the perianal area, what is the best nursing goal?

• A. Ensure that the bed linen is always dry
• B. Frequently check the bed for wetness and keep it dry
• C. Place a rubber sheet under the client's buttocks
• D. Keep the patient clean and dry

Correct answer: A

Rationale: The best nursing goal for an incontinent elderly client with skin excoriation is to ensure that the bed linen is always dry. This helps in preventing further skin breakdown and promoting skin integrity. Choice B, to frequently check the bed for wetness and keep it dry, may not address the issue of prevention if the linen is not consistently dry. Choice C, placing a rubber sheet under the client's buttocks, focuses more on protecting the mattress rather than addressing the client's skin condition directly. Choice D, keeping the patient clean and dry, is important but does not specifically address the preventive aspect of maintaining dry bed linen.

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