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. Mrs. Seva also tells the nurse that she is often constipated. Because she is aging, what physical changes predispose her to constipation?

• A. inhibition of the parasympathetic reflex
• B. weakness of sphincter muscles of anus
• C. loss of tone of the smooth muscles of the colon
• D. decreased ability to absorb fluids in the lower intestines

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

3. For an incontinent elderly client who frequently wets his bed and develops redness and skin excoriation at the perianal area, what is the best nursing goal?

• A. Ensure that the bed linen is always dry
• B. Frequently check the bed for wetness and keep it dry
• C. Place a rubber sheet under the client's buttocks
• D. Keep the patient clean and dry

Correct answer: A

Rationale: The best nursing goal for an incontinent elderly client with skin excoriation is to ensure that the bed linen is always dry. This helps in preventing further skin breakdown and promoting skin integrity. Choice B, to frequently check the bed for wetness and keep it dry, may not address the issue of prevention if the linen is not consistently dry. Choice C, placing a rubber sheet under the client's buttocks, focuses more on protecting the mattress rather than addressing the client's skin condition directly. Choice D, keeping the patient clean and dry, is important but does not specifically address the preventive aspect of maintaining dry bed linen.

4. _____ 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.

5. A client with diabetes is being taught by a nurse about the dietary source that should provide the greatest percentage of calories. Which of the following statements indicates the client understands the teaching?

• A. "Most of my calories each day should be from fats."?
• B. "I should eat more calories from complex carbohydrates than anything else."?
• C. "Simple sugars are needed more than other calorie sources."?
• D. "Protein should be my main source of calories."?

Correct answer: B

Rationale: The correct answer is '"I should eat more calories from complex carbohydrates than anything else."?' Clients with diabetes should focus on complex carbohydrates as their primary calorie source because they have a lower impact on blood sugar levels compared to simple sugars or fats. Choice A is incorrect because a high intake of fats can lead to various health issues. Choice C is incorrect because simple sugars can cause rapid spikes in blood sugar levels. Choice D is incorrect as while protein is important, it should not be the main source of calories for someone with diabetes.

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