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. Stimulates secretion of bicarbonate ions and digestive enzymes from the pancreas to the small intestine:

• A. pepsin
• B. salivary amylase
• C. CCK
• D. secretin

Correct answer: D

Rationale: Secretin stimulates the pancreas to release bicarbonate ions to neutralize stomach acid and digestive enzymes into the small intestine.

3. This flip-over card is usually kept in a portable file at the Nurse’s Station. It has 2-parts: the activity and treatment section and a nursing care plan section. This carries information about basic demographic data, primary medical diagnosis, current orders of the physician to be carried out by the nurse, written nursing care plan, nursing orders, scheduled tests and procedures, safety precautions in patient care and factors related to daily living activities. This record is used in the charge-of-shift reports or during the bedside rounds or walking rounds. What record is this?

• A. Discharge Summary
• B. Medicine and Treatment Record
• C. Nursing Health History and Assessment Worksheet
• D. Nursing Kardex

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

4. What food would most likely be included in Level 1 of the National Dysphagia Diet?

• A. peanut butter
• B. oatmeal
• C. fruit preserves
• D. plain yogurt

Correct answer: D

Rationale: The correct answer is D, plain yogurt. Level 1 of the National Dysphagia Diet includes pureed or smooth foods that are easy to swallow. Plain yogurt fits this criteria as it is smooth and can be easily consumed without posing a risk of choking. Choices A, B, and C are not typically included in Level 1 of the diet. Peanut butter, oatmeal, and fruit preserves are not usually suitable for individuals on Level 1 of the National Dysphagia Diet as they may present a choking hazard or are not in a pureed or smooth form.

5. What type of gastrointestinal complication is most likely to be caused by the use of antibiotics to treat H. pylori infection?

• A. Hemoptysis
• B. Altered taste sensation
• C. Flatulence
• D. Bloody stools

Correct answer: B

Rationale: The correct answer is B, Altered taste sensation. The use of antibiotics is known to cause changes in taste sensation as a side effect, especially when used to treat H. pylori infections. Hemoptysis (Choice A) refers to coughing up blood, and while it can be a symptom of various conditions, it is not typically associated with the use of antibiotics. Flatulence (Choice C) and bloody stools (Choice D) can also occur as gastrointestinal complications, but they are not the most likely side effect when treating H. pylori with antibiotics. Therefore, choices A, C, and D are incorrect.

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