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. 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. Which symptoms are associated with cancer of the colon?

• A. constipation, ascites, and mucus in the stool
• B. diarrhea, heartburn, and eructation
• C. blood in the stools, anemia, and 'pencil-shaped' stools
• D. anorexia, hematemesis, and increased peristalsis

Correct answer: C

Rationale: The correct symptoms associated with cancer of the colon are blood in the stools, anemia, and 'pencil-shaped' stools. These symptoms are classic indicators of colorectal cancer. Choices A, B, and D do not typically present in colorectal cancer. Constipation, ascites, and mucus in the stool are more commonly associated with other gastrointestinal conditions. Diarrhea, heartburn, and eructation are not typical symptoms of colon cancer. Anorexia, hematemesis, and increased peristalsis are more indicative of other gastrointestinal issues and not specific to colon cancer.

4. What would you do to increase the amount of iron absorbed from a meal?

• A. Drink plenty of coffee before each meal
• B. Avoid eating foods rich in vitamin C with the meal
• C. Eat a calcium-rich food with the meal
• D. Consume orange juice as a beverage with a meal

Correct answer: D

Rationale: The correct answer is D: 'Consume orange juice as a beverage with a meal'. This is because Vitamin C significantly enhances the absorption of non-heme iron, a form of iron found in plant-based foods. Therefore, consuming orange juice, which is rich in vitamin C, with a meal can effectively increase iron absorption. On the contrary, choices A, B, and C are incorrect. Coffee (Choice A) contains polyphenols that can inhibit iron absorption. Avoiding vitamin C-rich foods (Choice B) would decrease iron absorption, not increase it. While calcium (Choice C) is essential for many bodily processes, it can actually inhibit iron absorption when consumed together.

5. 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).

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