Nursing Elites

1. One of the most common factors that compromise the vitamin D status of older adults, particularly those living in assisted living communities is _____.

• A. decreased intake of fruits and vegetables
• B. lack of physical activity
• C. malabsorption due to atrophic gastritis
• D. lack of exposure to sunlight

Correct answer: D

Rationale: The correct answer is 'D: lack of exposure to sunlight.' Older adults, especially those in assisted living communities, are at risk of vitamin D deficiency due to spending most of their time indoors, which reduces their exposure to sunlight. Sunlight is essential for the body to produce vitamin D. Choices A, B, and C are less likely to be major factors in compromising vitamin D status. While a decreased intake of fruits and vegetables and lack of physical activity can impact overall health, they are not as directly related to vitamin D status. Malabsorption due to atrophic gastritis may affect the absorption of certain nutrients, but vitamin D synthesis primarily depends on sunlight exposure.

2. High blood pressure is defined as systolic and diastolic measurements greater than or equal to:

• A. 140 mm Hg and 90 mm Hg, respectively
• B. 150 mm Hg and 80 mm Hg, respectively
• C. 160 mm Hg and 110 mm Hg, respectively
• D. 180 mm Hg and 120 mm Hg, respectively

Correct answer: A

Rationale: High blood pressure, or hypertension, is typically defined as having a systolic pressure of 140 mm Hg or higher and/or a diastolic pressure of 90 mm Hg or higher. Therefore, the correct answer is A. Choice B is incorrect because it suggests a higher systolic measurement than the standard definition. Choice C is incorrect as it provides an even higher systolic measurement and a much higher diastolic measurement. Choice D is also incorrect as it suggests extremely elevated blood pressure values, well above the typical definition of hypertension.

3. Which systemic disease is best controlled with the DASH diet, monitoring blood pressure, limiting sodium, alcohol, and caffeine, reducing stress, and losing weight?

• A. Hypertension
• B. Diabetes mellitus
• C. Parkinson's disease
• D. Anemia

Correct answer: A

Rationale: The correct answer is A: Hypertension. The DASH diet is specifically designed to control hypertension by reducing sodium intake, managing blood pressure, and promoting overall cardiovascular health. Choice B, Diabetes mellitus, is managed through monitoring blood sugar levels and a balanced diet rich in whole grains, fruits, and vegetables. Choice C, Parkinson's disease, is a neurological disorder that is not primarily managed through diet modifications. Choice D, Anemia, is a condition characterized by a lack of healthy red blood cells and is typically managed by addressing the underlying cause and sometimes iron supplementation, not by the methods mentioned in the question.

4. What is the role of fat in digestion?

• A. Digest fats in the stomach
• B. Emulsify fats in the small intestine
• C. Transport fats through the circulatory system
• D. Split fats into smaller components

Correct answer: B

Rationale: The correct answer is B: Emulsify fats in the small intestine. Bile emulsifies fats in the small intestine, breaking them down into smaller droplets that can be more easily digested by enzymes like lipase. Choice A is incorrect as fats are not digested in the stomach but rather in the small intestine. Choice C is incorrect as fats are transported through the lymphatic system instead of the circulatory system. Choice D is incorrect as fats are broken down into smaller components through emulsification, not splitting.

5. Which of the following actions would be of highest priority with regards to the external shunt?

• A. Avoid taking blood pressure or blood sample from the arm with the shunt
• B. Instruct the patient not to exercise the arm with the shunt
• C. Heparinize the shunt daily
• D. Change the dressing of the shunt daily

Correct answer: C

Rationale: Heparinizing the shunt daily (choice C) is the highest priority action as it prevents the formation of blood clots that can occlude the shunt, leading to potential complications such as thrombosis. Avoiding taking blood pressure or blood samples from the arm with the shunt (choice A) is also important, but secondary to heparinizing the shunt. Similarly, instructing the patient not to exercise the arm with the shunt (choice B) can help prevent unnecessary strain on the shunt, but it is not as critical as preventing clot formation. Changing the dressing of the shunt daily (choice D) is a standard nursing care practice to prevent infection, but again, it is not as critical as ensuring the shunt remains patent through daily heparinization.

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