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. A nurse is providing teaching to an obese client who has gestational diabetes and is at 25 weeks of gestation. Which of the following statements made by the client indicates a need for further teaching?

• A. This does not mean that my baby will have this disease.
• B. This means that I will have diabetes for the rest of my life.
• C. If I feel dizzy, I should drink six ounces of a non-diet soda.
• D. Being obese might be one reason why I developed diabetes.

Correct answer: B

Rationale: The statement 'This means that I will have diabetes for the rest of my life' indicates a need for further teaching. Gestational diabetes often resolves after pregnancy, although it does indicate a higher risk for developing type 2 diabetes in the future. The other choices are correct or provide appropriate information: A) Understanding that gestational diabetes does not mean the baby will have the disease is accurate. C) Advising to drink non-diet soda if feeling dizzy is incorrect and potentially harmful due to the sugar content. D) Recognizing that obesity can be a risk factor for developing diabetes is a valid statement.

3. A factor contributing to the risk for dehydration in the older adult is that _____.

• A. drinking fluids causes loss of bladder control
• B. older adults do not seem to notice mouth dryness as readily as younger people
• C. increased fluid intake will decrease the intake of nutrient-dense foods
• D. changes in intestinal motility contribute to excess fluid loss

Correct answer: C

Rationale: Older adults may not notice mouth dryness as readily as younger individuals, increasing their risk for dehydration, especially if they do not consciously increase fluid intake.

4. Substance abuse is different from substance dependence in that, substance dependence:

• A. includes characteristics of adverse consequences and repeated use
• B. requires long term treatment in a hospital based program
• C. produces less severe symptoms than that of abuse
• D. includes characteristics of tolerance and withdrawal

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.

5. During the Emergent phase of a burn, the most fatal electrolyte imbalance in a burned client is:

• A. Hypokalemia
• B. Hyperkalemia
• C. Hypernatremia
• D. Hyponatremia

Correct answer: A

Rationale: During the Emergent phase of burns, the most fatal electrolyte imbalance is Hypokalemia. This is due to the shift of potassium from the intracellular space to the extracellular space, leading to low potassium levels in the blood. Choices B, C, and D are incorrect because Hyperkalemia, Hypernatremia, and Hyponatremia are not typically associated with the Emergent phase of burns and do not pose the same level of risk as Hypokalemia in this context.

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