Nursing Elites

1. Which cells in the islet of the pancreas are responsible for synthesizing insulin?

• A. Alpha cells
• B. Beta cells
• C. Gamma cells
• D. Delta cells

Correct answer: B

Rationale: Beta cells in the islets of Langerhans in the pancreas are responsible for the production and secretion of insulin, which is crucial for regulating blood glucose levels. Alpha cells, on the other hand, produce glucagon, a hormone that raises blood glucose levels. Gamma cells and Delta cells do not exist in the islets of Langerhans; therefore, they are incorrect choices.

2. Each of the following is a function of vitamin A, except one. Which is the exception?

• A. Prevention of night blindness
• B. Growth of soft tissues and bone
• C. Maintenance of more than 200 genes
• D. Integrity of body openings and their linings

Correct answer: C

Rationale: The correct answer is C. Maintenance of more than 200 genes is not a function of vitamin A; instead, it is a function of Vitamin D. Vitamin A plays a crucial role in the prevention of night blindness by aiding in the production of the visual pigment rhodopsin. It also supports the growth of soft tissues and bone, as well as the integrity of body openings and their linings. Choice C is incorrect because the maintenance of genes is primarily associated with Vitamin D, not Vitamin A.

3. Patients maintained using peritoneal dialysis may gain weight because:

• A. their appetite is increased
• B. physical activity is limited
• C. they absorb glucose from the dialysate
• D. they absorb amino acids from the dialysate

Correct answer: C

Rationale: Glucose from the peritoneal dialysis solution can be absorbed into the bloodstream, leading to weight gain if not balanced with diet and activity.

4. 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.

5. _____ neutralizes stomach acid in the small intestine:

• A. saliva
• B. gastric mucus
• C. bicarbonate ions
• D. enzymes

Correct answer: C

Rationale: The correct answer is C: bicarbonate ions. Bicarbonate ions, secreted by the pancreas, neutralize the acidic chyme entering the small intestine from the stomach, creating a more suitable environment for digestive enzymes. Saliva (choice A) helps in the initial breakdown of food in the mouth, not in neutralizing stomach acid. Gastric mucus (choice B) protects the stomach lining from the acidic environment but does not neutralize the acid in the small intestine. Enzymes (choice D) facilitate chemical reactions in digestion but do not neutralize stomach acid.

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