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Which female patient is most likely to have metabolic syndrome?
- A. BP 128/78 mm Hg, triglycerides 160 mg/dL, fasting blood glucose 102 mg/dL
- B. BP 142/90 mm Hg, high-density lipoproteins 45 mg/dL, fasting blood glucose 130 mg/dL
- C. Waist circumference 36 in, triglycerides 162 mg/dL, high-density lipoproteins 55 mg/dL
- D. Waist circumference 32 in, high-density lipoproteins 38 mg/dL, fasting blood glucose 122 mg/dL
Correct Answer: B
Rationale: The correct answer is B because the patient's blood pressure, HDL levels, and fasting blood glucose levels all indicate a higher likelihood of metabolic syndrome. High blood pressure, low HDL levels, and elevated blood glucose are key components of metabolic syndrome.
Option A has normal blood pressure and slightly elevated triglycerides and blood glucose, but not as concerning as choice B.
Option C has a normal blood pressure, slightly elevated triglycerides, and good HDL levels, which lowers the likelihood of metabolic syndrome.
Option D has a normal blood pressure, very low HDL levels, and slightly elevated blood glucose, but the blood pressure is not in the hypertensive range as in choice B.
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To evaluate the effect of nutritional interventions for a patient with protein-calorie malnutrition, what is the best indicator for the nurse to use?
- A. Height and weight
- B. Weight in relation to ideal body weight
- C. Body mass index (BMI)
- D. Mid-upper arm circumference and triceps skinfold
Correct Answer: D
Rationale: The correct answer is D. Mid-upper arm circumference and triceps skinfold are commonly used indicators to assess muscle and fat reserves in individuals with protein-calorie malnutrition. Mid-upper arm circumference reflects muscle mass, while triceps skinfold measures body fat. These indicators provide a comprehensive assessment of the patient's nutritional status, making them the best choice for evaluating the effectiveness of nutritional interventions.
A: Height and weight do not provide a specific assessment of muscle and fat reserves and may not accurately reflect changes in nutritional status.
B: Weight in relation to ideal body weight does not differentiate between muscle and fat mass, making it less specific for assessing protein-calorie malnutrition.
C: BMI is a general indicator of weight status and does not specifically measure muscle and fat reserves, making it less suitable for evaluating nutritional interventions in patients with protein-calorie malnutrition.
A two-week-old boy develops persistent projectile vomiting. The most likely diagnosis is:
- A. pyloric stenosis
- B. esophageal atresia
- C. annular pancreas
- D. incomplete rotation of the gut
Correct Answer: A
Rationale: The correct answer is A: pyloric stenosis. In pyloric stenosis, there is hypertrophy of the pyloric sphincter muscle, leading to gastric outlet obstruction and projectile vomiting. This typically presents in infants around 2-6 weeks of age. Other choices (B) esophageal atresia presents with difficulty feeding and choking, (C) annular pancreas with duodenal obstruction, and (D) incomplete rotation of the gut with volvulus or obstruction due to malrotation. Pyloric stenosis is the most likely diagnosis in this scenario based on the age of the infant and the symptom of projectile vomiting.
Where does chemical digestion of carbohydrates begin?
- A. Mouth
- B. Stomach
- C. Small intestine
- D. Large intestine
Correct Answer: A
Rationale: The correct answer is A: Mouth. In the mouth, salivary amylase is secreted, which starts breaking down carbohydrates into simpler sugars like maltose. This initial breakdown of carbohydrates through the enzyme amylase marks the beginning of chemical digestion. The stomach primarily digests proteins, not carbohydrates (eliminating option B). The small intestine is where most of the carbohydrate digestion and absorption occurs, but the process begins in the mouth (eliminating option C). The large intestine is responsible for absorbing water and electrolytes, not carbohydrate digestion (eliminating option D).
Na and other carrier ions facilitate absorption of
- A. amino acids and fructose
- B. fatty acids and glycerol
- C. fatty acids and glucose
- D. amino acids and glucose
Correct Answer: D
Rationale: The correct answer is D: amino acids and glucose. Na ions facilitate the absorption of these molecules in the small intestine through the process of co-transport with carrier proteins. Glucose and amino acids are primarily absorbed in the small intestine to be utilized by the body for energy and growth. Na ions help transport these molecules across the intestinal epithelium against their concentration gradients.
A: Amino acids and fructose - While Na ions do play a role in the absorption of amino acids, fructose is primarily absorbed through facilitated diffusion and does not require Na ions for absorption.
B: Fatty acids and glycerol - Fatty acids and glycerol are absorbed in the small intestine through a different mechanism called micelle formation and do not rely on Na ions for absorption.
C: Fatty acids and glucose - While Na ions do play a role in the absorption of glucose, fatty acids are primarily absorbed through micelle formation and do not require Na ions for absorption.
What is the fate of any excess glucose that goes to the liver that is not required for energy and not stored as glycogen?
- A. it is converted into fat
- B. it is converted into protein
- C. it is immediately released back into the bloodstream
- D. it is degraded
Correct Answer: A
Rationale: The correct answer is A: it is converted into fat. Excess glucose not needed for immediate energy or stored as glycogen is converted into fat through a process called de novo lipogenesis in the liver. This occurs when glucose levels are high and glycogen stores are full. The liver converts the excess glucose into fatty acids and then into triglycerides for storage in adipose tissue. This process helps regulate blood glucose levels and prevents hyperglycemia.
Other choices are incorrect:
B: Glucose is not directly converted into protein. Proteins are synthesized from amino acids, not glucose.
C: Releasing excess glucose back into the bloodstream would lead to high blood sugar levels, which is not a typical physiological response.
D: Glucose is not simply degraded; it is either used for energy, stored as glycogen, or converted into fat when in excess.