Nursing Elites

1. Which types of diabetes are characterized by the body's cells becoming resistant to insulin? (Select all that apply)

• A. Gestational diabetes
• B. Type II diabetes
• C. Type I diabetes
• D. Both A and B

Correct answer: D

Rationale: In both gestational diabetes and Type II diabetes, the body's cells become resistant to insulin, leading to elevated blood glucose levels. Insulin resistance in these types of diabetes prevents glucose from entering the cells, causing it to accumulate in the bloodstream. On the other hand, Type I diabetes is characterized by the body's inability to produce insulin because the immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas. Therefore, the correct answer is both A and B. Choice C, Type I diabetes, is not characterized by insulin resistance but rather by the body's inability to produce insulin. Therefore, it is incorrect. Choice D, Both A and B, includes the correct options of gestational diabetes and Type II diabetes, making it the correct answer.

2. During an initial visit with an older adult client living alone and having difficulty preparing meals, what should the home health nurse do first?

• A. Discuss nutritional requirements with the client.
• B. Refer the client to a senior citizen center.
• C. Arrange for a home-delivered meal program.
• D. Perform a nutrition screening.

Correct answer: D

Rationale: Performing a nutrition screening is the most appropriate action for the nurse to take first. This allows the nurse to assess the client's current nutritional status and identify any specific needs. Discussing nutritional requirements with the client (Choice A) may be important but should come after the initial assessment. Referring the client to a senior citizen center (Choice B) or arranging for a home-delivered meal program (Choice C) are actions that may be considered later based on the findings of the nutrition screening.

3. A nurse is caring for a client who is to receive a mechanically altered diet. Which of the following client food choices necessitates intervention by the nurse?

• A. Scrambled eggs
• B. Cottage cheese
• C. Piece of wheat toast
• D. Sliced banana

Correct answer: D

Rationale: The correct answer is 'Sliced banana.' A mechanically altered diet is designed for clients who have difficulty chewing or swallowing. Sliced bananas, due to their texture and potential choking hazard for clients with swallowing difficulties, would necessitate intervention by the nurse. Scrambled eggs, cottage cheese, and a piece of wheat toast are softer and safer options for clients on a mechanically altered diet, making them appropriate choices.

4. Which enzyme initiates protein digestion in the stomach?

• A. Pepsin
• B. Salivary Amylase
• C. CCK
• D. Secretin

Correct answer: A

Rationale: Pepsin is the enzyme that initiates protein digestion in the stomach. It breaks down proteins into smaller peptides, aiding in their further digestion and absorption in the intestines. Salivary Amylase (Choice B) functions in breaking down dietary carbohydrates in the mouth, not proteins. CCK (Choice C) and Secretin (Choice D) are hormones involved in the digestion of fats and carbohydrates, not proteins. Therefore, Choices B, C, and D are incorrect in the context of protein digestion in the stomach.

5. Clients with type 2 diabetes are most likely to achieve metabolic control if they:

• A. lose weight
• B. use self-monitoring of blood glucose
• C. eliminate all dietary sugars
• D. eat three regular meals daily

Correct answer: A

Rationale: Weight loss improves insulin sensitivity and glycemic control, making it a key strategy in managing type 2 diabetes.

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