when assessing for criteria that signify malnutrition risk which element would most likely be included as part of the functional assessment data
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Nursing Elites

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1. When assessing for criteria that signify malnutrition risk, which element would most likely be included as part of the functional assessment data?

Correct answer: D

Rationale: Generalized weakness is a key indicator of malnutrition and is often assessed as part of functional status, reflecting muscle wasting and reduced physical function. The other choices, such as severity of illness, presence of pressure sores, and localized edema, are important factors to consider in a clinical assessment but are not primarily indicative of malnutrition risk. Generalized weakness directly relates to the functional impact of malnutrition on physical performance.

2. What health instruction will enhance regulation of a colostomy (defecation) of clients?

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

3. Which enzyme digests fiber in the large intestine?

Correct answer: D

Rationale: The correct answer is 'none of the above.' Human digestive enzymes like salivary amylase and pancreatic amylase cannot digest fiber. Instead, fiber is fermented by gut bacteria in the large intestine. Cellulase, which is an enzyme produced by some animals and microorganisms, can break down cellulose found in plants, but it is not a human digestive enzyme, making it an incorrect choice in this context.

4. In an extreme situation and when no other resident or intern is available, should a nurse receive telephone orders, the order has to be correctly written and signed by the physician within:

Correct answer: B

Rationale: In an extreme situation where no other resident or intern is available, if a nurse receives telephone orders, the order has to be correctly written and signed by the physician within 36 hours. This time frame ensures timely documentation and validation of the orders. Choice A (24 hours) is too short a period for busy physicians to fulfill the task. Choice C (48 hours) is too long and delays the incorporation of physician orders into the patient's care plan. Choice D (12 hours) may not provide enough time for the physician to review and sign the order, especially in situations where immediate attention is not required.

5. Each is a characteristic manifestation of necrotizing ulcerative gingivitis (NUG), except one. Which is the exception?

Correct answer: C

Rationale: The correct answer is C: Marasmus. Marasmus is a form of severe malnutrition and is not a direct manifestation of necrotizing ulcerative gingivitis (NUG). Choices A, B, and D are all characteristic manifestations of NUG. Gingival erythema, necrosis of interdental papilla, and metallic taste with foul odor are commonly associated with NUG due to the inflammatory and necrotic nature of the condition.

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