Nursing Elites

1. Maternal malnutrition at a critical period of development may have lifelong effects on an individual's pattern of genetic expression and on the tendency to develop obesity, which is a concept known as _____.

• A. genetic determination
• B. metabolic tolerance
• C. chromosomal influence
• D. fetal programming

Correct answer: D

Rationale: Fetal programming refers to the concept that maternal nutrition during critical periods of development can have long-term effects on an individual's health and risk of diseases like obesity.

2. What type of drug therapy is typically administered immediately after a heart attack?

• A. Antilipemic drugs
• B. Corticosteroids
• C. Diuretics
• D. Thrombolytic drugs

Correct answer: D

Rationale: Thrombolytic drugs are typically administered immediately after a heart attack to dissolve the clot blocking the coronary artery and restore blood flow to the heart muscle. Antilipemic drugs are used to lower lipid levels and prevent atherosclerosis, but they are not typically administered immediately after a heart attack. Corticosteroids are used to reduce inflammation and suppress the immune response, which are not immediate concerns after a heart attack. Diuretics are used to reduce fluid build-up and lower blood pressure, but these are not the primary concerns immediately following a heart attack.

3. Which of the following are the primary bacteria involved in the initiation of dental caries?

• A. Streptococcus mutans and Lactobacillus species
• B. Salmonella and Listeria species
• C. Streptococcus, Lactobacillus, and Salmonella species
• D. Listeria, Botulinum species, and Escherichia coli

Correct answer: A

Rationale: The correct answer is A: Streptococcus mutans and Lactobacillus species. These bacteria are primarily responsible for initiating dental caries by fermenting carbohydrates and producing acids that demineralize enamel. Choice B, Salmonella and Listeria species, are not the primary bacteria involved in dental caries. Choice C includes Salmonella which is not a primary culprit in dental caries. Choice D lists Listeria, Botulinum species, and Escherichia coli, none of which are the primary bacteria associated with initiating dental caries.

4. In a patient with chronic kidney disease, which dietary modification is recommended?

• A. Increase protein intake
• B. Reduce potassium intake
• C. Increase sodium intake
• D. Reduce fiber intake

Correct answer: B

Rationale: Reducing potassium intake is important for patients with chronic kidney disease to prevent hyperkalemia.

5. 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.

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