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 type of nutritional deficiency results from inadequate absorption?

• A. Unmeasurable
• B. Primary deficiency
• C. Secondary deficiency
• D. Codependent

Correct answer: C

Rationale: The correct answer is C: Secondary deficiency. A nutritional deficiency resulting from decreased intake is called a primary deficiency. On the other hand, a secondary deficiency refers to a vitamin deficiency caused by inadequate absorption or use, increased requirements, excretion, or destruction. Choice A, 'Unmeasurable,' is incorrect as it does not describe a type of nutritional deficiency. Choice B, 'Primary deficiency,' is incorrect as it refers to a deficiency caused by decreased intake, not inadequate absorption. Choice D, 'Codependent,' is incorrect as it is unrelated to the context of nutritional deficiencies.

3. Bones continuously lose and gain minerals. This ongoing process is called?

• A. reorganization
• B. reorienting
• C. demineralizing
• D. remodeling

Correct answer: D

Rationale: The correct answer is D, 'remodeling.' Remodeling is the process by which bones continuously lose and gain minerals, maintaining bone strength and integrity over time. 'Reorganization' (choice A), 'reorienting' (choice B), and 'demineralizing' (choice C) do not accurately describe the process of bones continuously losing and gaining minerals.

4. Electrolytes create _____, which is caused by water following electrolytes within or between cells.

• A. energy
• B. active transport
• C. passive diffusion
• D. osmotic pressure

Correct answer: D

Rationale: Osmotic pressure is the force that drives water movement across cell membranes due to the presence of electrolytes, helping to balance fluid levels in the body. Choice A, 'energy,' is incorrect as electrolytes do not directly create energy. Choice B, 'active transport,' refers to the movement of molecules across a cell membrane requiring energy, not the movement of water. Choice C, 'passive diffusion,' is the process by which substances move from an area of higher concentration to lower concentration, not related to the movement of water following electrolytes.

5. A nurse is caring for four clients. The nurse should plan to administer total parenteral nutrition for which of the following clients?

• A. A client who is postoperative following a laminectomy and is receiving IV PCA
• B. A client who has dysphagia and does not recognize his family
• C. A client who has COPD and is going home with oxygen
• D. A client who has colon cancer and will undergo a hemicolectomy

Correct answer: D

Rationale: Total parenteral nutrition (TPN) is essential for clients undergoing significant surgical procedures like a hemicolectomy to ensure they receive adequate nutrition when oral intake is not possible. Choices A, B, and C do not typically require TPN. Choice A is managing postoperative pain with IV PCA, choice B is likely to need alternative feeding methods due to dysphagia, and choice C is going home with oxygen for COPD management, which does not directly relate to the need for TPN.

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