Nursing Elites

1. The mechanism behind most CKD in patients without diabetes is mediated by:

• A. enzyme systems
• B. immune systems
• C. catabolic systems
• D. hormonal systems

Correct answer: B

Rationale: In non-diabetic patients, CKD is often mediated by immune system responses. Chronic inflammation triggered by immune system dysfunction can contribute to progressive kidney damage. Therefore, the correct answer is 'immune systems.' Choices A, C, and D are incorrect because CKD in non-diabetic patients is primarily associated with immune system abnormalities rather than enzyme, catabolic, or hormonal systems.

2. Select all that apply. Which of the following are true about protein digestion?

• A. the end products of protein digestion are amino acids
• B. protein/polypeptides are digested in the large intestine by trypsin
• C. A, D
• D. protein/polypeptides are digested in the stomach by pepsin

Correct answer: C

Rationale: Protein digestion begins in the stomach with the enzyme pepsin, which breaks down proteins into smaller polypeptides. The end products of protein digestion are amino acids.

3. A nurse is caring for a client following a CVA and observes the client experiencing severe dysphagia. The nurse notifies the provider. Which of the following nutritional therapies will likely be prescribed?

• A. NPO until dysphagia subsides
• B. Supplements via nasogastric tube
• C. Initiation of total parenteral nutrition
• D. Soft residue diet

Correct answer: B

Rationale: In the scenario of severe dysphagia following a CVA, the client may have difficulty swallowing and require alternative nutritional support. Providing supplements via a nasogastric tube allows for the delivery of essential nutrients directly into the stomach, bypassing the swallowing difficulties. NPO (nothing by mouth) until dysphagia subsides may be too restrictive for the client's nutritional needs. Initiation of total parenteral nutrition is usually reserved for cases where enteral feeding is not possible or contraindicated. A soft residue diet may not be suitable for a client experiencing severe dysphagia.

4. During early tooth development, vitamin A deficiency leads to enamel hypoplasia and defective dentin formation. Because of its effect on soft tissues and bone, vitamin A contributes to normal spacing of teeth.

• A. Both statements are true.
• B. Both statements are false.
• C. The first statement is true; the second is false.
• D. The first statement is false; the second is true.

Correct answer: A

Rationale: Both statements are true. The effect of vitamin A on the growth of soft tissues and bones naturally extends to the teeth and surrounding structures. Enamel hypoplasia, involving defective enamel matrix and incomplete calcification of enamel and dentin, can be due to vitamin A deficiency. The effect of this vitamin upon surrounding bone directly affects spacing patterns of the teeth within the bone and dentition. Choice A is correct because both statements accurately describe the influence of vitamin A on tooth development. Choices B, C, and D are incorrect as they do not reflect the accuracy of the statements provided.

5. Which foods are the biggest contributors of saturated fats consumed by Americans?

• A. Butter, coconut, and palm oils
• B. Corn oil
• C. Meat and milk
• D. Cheese, pizza, desserts, and chicken

Correct answer: D

Rationale: The correct answer is D: Cheese, pizza, desserts, and chicken. These foods are significant contributors to the intake of saturated fats in the American diet, often found in processed and fast foods. Choices A, B, and C are incorrect because while butter, coconut, and palm oils (A) are sources of saturated fats, they are not the biggest contributors in the American diet. Corn oil (B) is a source of unsaturated fats, and meat and milk (C) contain saturated fats but are not the primary contributors compared to cheese, pizza, desserts, and chicken.

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