Nursing Elites

1. A client with nephropathy secondary to diabetes mellitus is receiving dietary teaching from a nurse and plans to make dietary adjustments. Which of the following instructions should the nurse include?

• A. Consume less than 45% of total calories from carbohydrates per day.
• B. Eat no more than 300 mg of cholesterol per day.
• C. Consume less than 0.8 g/kg of body weight of protein per day.
• D. Eat at least 45 g of fiber per day.

Correct answer: D

Rationale: For a client with nephropathy secondary to diabetes mellitus, increasing fiber intake is essential as it can help manage blood sugar levels and improve overall bowel health. Choice A is incorrect because carbohydrates should be controlled but not limited to less than 45% of total calories. Choice B is incorrect as the recommended daily cholesterol intake for individuals with diabetes is less than 200 mg. Choice C is incorrect as protein intake should be individualized based on the client's condition and should not be limited to less than 0.8 g/kg of body weight per day.

2. Is the statement 'The metabolic rate is the highest after a few hours of sleep' true or false?

• A. True
• B. False
• C.
• D.

Correct answer: B

Rationale: The statement is false. The metabolic rate is actually lowest during sleep and increases upon waking. During sleep, the body conserves energy, leading to a lower metabolic rate. As the body wakes up and becomes active, the metabolic rate increases to support the body's functions and energy needs. Therefore, the metabolic rate is not the highest after a few hours of sleep, making the statement false.

3. A healthcare provider is providing teaching about nutrition to a group of clients. The healthcare provider should include that which of the following foods contains the highest level of thiamine per serving?

• A. 1 hard-boiled egg
• B. 1 cup dried pears
• C. 1 cup whole grain wheat flour
• D. 1 cup Brussels sprouts

Correct answer: C

Rationale: Whole grain wheat flour contains the highest level of thiamine per serving compared to the other options provided. Thiamine, also known as Vitamin B1, is essential for energy metabolism. While eggs, dried pears, and Brussels sprouts are nutritious foods, they do not contain as high a level of thiamine as whole grain wheat flour. Therefore, the correct choice is whole grain wheat flour in this case.

4. How is the stomach protected from damage by gastric acid?

• A. enzymes present in the stomach
• B. a protective bacteria in the stomach
• C. bicarbonate present in the stomach
• D. the mucus lining of the stomach

Correct answer: D

Rationale: The correct answer is D. The stomach is protected from gastric acid by a thick mucus lining that acts as a physical barrier, preventing the acid from eroding the stomach walls. Enzymes in the stomach help with digestion but do not play a significant role in protecting the stomach from acid damage, so choice A is incorrect. While some bacteria in the stomach can be beneficial, they do not primarily protect the stomach from gastric acid, making choice B incorrect. Bicarbonate, a base, can neutralize acid, but it is not the primary defense mechanism against gastric acid in the stomach, so choice C is also incorrect.

5. In taking the client’s blood pressure, the nurse should position the client’s arm:

• A. At the level of the heart
• B. Slightly above the level of the heart
• C. At the 5th intercostals space midclavicular line
• D. Below the level of the heart

Correct answer: A

Rationale: Proper patient positioning is essential for maximizing lung expansion and promoting the drainage of secretions. Postural drainage techniques rely on gravity to help clear different lung segments, which is critical in preventing complications such as atelectasis or pneumonia in immobilized patients.

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