Nursing Elites

1. When counseling a teenager about fast food, a dental hygienist could correctly cite which of the following facts, with one exception. Which is the exception?

• A. Most fast food menus lack a rich source of vitamin A
• B. Consumer demands have driven the establishment of salads and other healthy menu items
• C. Shortages of biotin, folate, pantothenic acid, and copper are reported in fast foods
• D. Studies reveal that protein is lacking in most menu items

Correct answer: D

Rationale: The correct answer is 'D'. Fast food is generally not deficient in protein since it often contains meat, a significant source of protein. On the other hand, fast food is known to lack essential nutrients like Vitamin A and certain minerals, as mentioned in choices 'A' and 'C'. Choice 'B' is also accurate as many fast food establishments have started offering healthier options such as salads due to customer demands. Therefore, all options are true except 'D', which makes it the exception.

2. Which of the following terms describes the amount of blood ejected per heartbeat?

• A. Stroke volume
• B. Cardiac output
• C. Ejection fraction
• D. Afterload

Correct answer: A

Rationale: The correct answer is A: Stroke volume. Stroke volume refers to the amount of blood ejected by the left ventricle in one contraction. Choice B, Cardiac output, is the total volume of blood pumped by the heart per minute and is calculated by multiplying stroke volume by heart rate. Choice C, Ejection fraction, is the percentage of blood pumped out of the left ventricle with each heartbeat. Choice D, Afterload, refers to the pressure or resistance that the ventricles must overcome to eject blood during systole. Therefore, in the context of the question, the term that specifically describes the amount of blood ejected per heartbeat is stroke volume.

3. The home health nurse visits older adult clients at an assisted living center. Which foods should the nurse recommend to correct the main nutrient deficits for this population?

• A. Carbohydrates
• B. Oily fish and krill oil
• C. Yellow vegetables
• D. Dairy products

Correct answer: D

Rationale: The correct answer is D: Dairy products. Older adults are often deficient in calcium and vitamin D, which are abundant in dairy products. These nutrients are essential for maintaining bone health. Choice A (Carbohydrates) is incorrect because while carbohydrates are an essential nutrient, they are not specifically addressing the main nutrient deficits for older adults. Choice B (Oily fish and krill oil) is incorrect as these foods are sources of omega-3 fatty acids and not specifically addressing the main nutrient deficits common in older adults. Choice C (Yellow vegetables) is incorrect because although vegetables are important for overall health, they do not directly address the main nutrient deficits typically seen in older adults.

4. Why are blood glucose levels high in type 1 diabetes?

• A. The urinary excretion of glucose is impaired
• B. The lean body mass is metabolized to produce glucose via gluconeogenesis
• C. The absorption of glucose from the gastrointestinal tract is more efficient
• D. There is insufficient insulin to facilitate the transport of glucose into the cells

Correct answer: D

Rationale: In type 1 diabetes, the body's immune system destroys the beta cells in the pancreas that produce insulin. This leads to an insufficient amount of insulin, which is required to facilitate the transport of glucose into the cells. Consequently, blood glucose levels remain high. The other options are incorrect. Option A is incorrect because urinary excretion of glucose does not directly contribute to blood glucose levels. Option B is incorrect because, while gluconeogenesis does produce glucose, it is not the cause of high glucose levels in type 1 diabetes. Option C is incorrect because absorption efficiency of glucose from the gastrointestinal tract does not affect the amount of insulin available to transport glucose into cells.

5. What is the glomerular filtration rate for patients with stage 5 chronic kidney disease (CKD)?

• A. Less than 15 mL/min/1.73 m�
• B. Less than 30 mL/min/1.73 m�
• C. Less than 90 mL/min/1.73 m�
• D. Less than 125 mL/min/1.73 m�

Correct answer: A

Rationale: In patients with stage 5 chronic kidney disease (CKD), also known as end-stage renal disease, the kidney function is significantly compromised. This severe condition is characterized by a glomerular filtration rate (GFR) of less than 15 mL/min/1.73 m�, as correctly stated in choice A. Choices B, C, and D suggest higher GFR values, which are not indicative of stage 5 CKD. Specifically, a GFR of less than 30 mL/min/1.73 m� indicates stage 4 CKD, less than 90 mL/min/1.73 m� signifies stage 3 CKD, and a typical healthy individual usually has a GFR of around 125 mL/min/1.73 m�, which is far above the GFR for stage 5 CKD.

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