Nursing Elites

1. What stimulates bile secretion from the liver to the small intestine?

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

Correct answer: C

Rationale: Cholecystokinin (CCK) is the hormone that stimulates the release of bile from the gallbladder into the small intestine, aiding in fat digestion. Pepsin is an enzyme in the stomach that breaks down proteins into smaller peptides, not involved in bile secretion. Salivary Amylase is an enzyme in saliva that initiates starch digestion in the mouth, not related to bile secretion. Secretin is a hormone that regulates the release of gastric juice in the stomach and triggers the pancreas to neutralize stomach acid in the small intestine, but it does not stimulate bile secretion.

2. A client with pre-dialysis end-stage kidney disease is being taught about diet. Which of the following instructions should the nurse include?

• A. Increase intake of dietary phosphorus.
• B. Eliminate foods high in protein from your diet.
• C. Reduce intake of foods high in potassium.
• D. Increase intake of sodium-containing foods.

Correct answer: C

Rationale: In pre-dialysis end-stage kidney disease, reducing intake of foods high in potassium is crucial as impaired kidney function can lead to potassium buildup in the blood, which can be dangerous. High potassium levels can cause irregular heartbeats and even cardiac arrest. Therefore, advising the client to reduce potassium-rich foods is essential to prevent complications. Choices A, B, and D are incorrect. Increasing dietary phosphorus, eliminating foods high in protein, or increasing sodium-containing foods are not appropriate recommendations for a client with pre-dialysis end-stage kidney disease as they can exacerbate the condition.

3. What primarily determines the Dietary Reference Intake (DRI) for protein?

• A. Intake of fatty acids
• B. Gender
• C. Height
• D. Body weight

Correct answer: D

Rationale: The Dietary Reference Intake (DRI) for protein is primarily determined by an individual's body weight. This is because the body's protein requirement is proportionate to its size, which is generally reflected in the body weight. Therefore, choice D is correct. Choices A, B, and C are incorrect: While factors such as fatty acid intake, gender, and height can influence an individual's overall nutritional needs, they do not directly determine the DRI for protein.

4. Membership dropout generally occurs in group therapy after a member:

• A. Accomplishes his goal in joining the group
• B. Discovers that his feelings are shared by the group members
• C. Experiences feelings of frustration in the group
• D. Discusses personal concerns with group members

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

5. A nurse is caring for a client with a major burn injury and is receiving TPN. Which of the following lab tests is the priority for the nurse to use to confirm the client is receiving adequate nutrition?

• A. Iron
• B. Magnesium
• C. Folic acid
• D. Prealbumin

Correct answer: D

Rationale: Prealbumin is a sensitive indicator of protein status and nutrition, making it a priority for assessing nutritional adequacy in clients receiving TPN. Iron, magnesium, and folic acid levels are important for overall health but do not specifically indicate nutritional adequacy in the context of TPN administration.

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