Nursing Elites

1. Which enzyme digests fiber in the large intestine?

• A. salivary amylase
• B. pancreatic amylase
• C. cellulase
• D. none of the above

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.

2. According to the dietary reference intakes, what percentage of your daily calorie intake should ideally come from carbohydrates?

• A. 10-35%
• B. 20-35%
• C. 40-50%
• D. 45-65%

Correct answer: D

Rationale: Carbohydrates should ideally make up 45-65% of your total daily caloric intake, according to the Dietary Reference Intakes (DRIs). This range provides the necessary energy for bodily functions and activities. Choices A, B, and C are incorrect because they fall outside the recommended range for carbohydrate intake based on the DRIs.

3. 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.

4. Integrated management for childhood illness is the universal protocol of care endorsed by WHO and is used by different countries worldwide, including the Philippines. In any case that the nurse classifies the child and categorizes the signs and symptoms in the PINK category, you know that this means:

• A. Urgent referral
• B. Antibiotic Management
• C. Home treatment
• D. Outpatient treatment facility is needed

Correct answer: B

Rationale: When a child is classified under the PINK category in the Integrated Management of Childhood Illness (IMCI) guidelines, it signifies the need for antibiotic management. This category indicates severe signs and symptoms requiring immediate antibiotic treatment to address the underlying infection. Choices A, C, and D are incorrect because the PINK category specifically calls for urgent antibiotic management rather than urgent referral, home treatment, or outpatient treatment facility.

5. Which of the following methods is the best method for determining nasogastric tube placement in the stomach?

• A. X-ray
• B. Observation of gastric aspirate
• C. Testing of pH of gastric aspirate
• D. Placement of external end of tube under water

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.

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