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. Which of the following best represents the goal of reflective listening?

• A. Repeating what the patient says
• B. Informing using direct advice
• C. Keeping the patient talking
• D. Warning the patient

Correct answer: C

Rationale: The correct answer is C. The goal of reflective listening is to keep the patient talking, allowing them to express their thoughts and concerns fully. Choice A, 'Repeating what the patient says,' is incorrect as reflective listening involves paraphrasing or summarizing rather than verbatim repetition. Choice B, 'Informing using direct advice,' is incorrect because reflective listening focuses on understanding the patient's perspective rather than providing direct advice. Choice D, 'Warning the patient,' is also incorrect as reflective listening aims to create a safe and open environment for the patient to share without feeling judged or warned.

3. Among people who are ill, significant weight loss may be masked by?

• A. dehydration
• B. a large tumor
• C. drug therapy
• D. fluid retention

Correct answer: D

Rationale: Fluid retention can mask weight loss in ill individuals as the retained fluid adds to body weight, making it difficult to detect true fat or muscle loss. Dehydration (Choice A) would actually lead to weight loss rather than masking it. While a large tumor (Choice B) could contribute to weight loss, it would not mask the weight loss itself. Drug therapy (Choice C) may cause side effects, including weight changes, but it is unlikely to mask significant weight loss in the same way that fluid retention does.

4. Nutritional goals for a patient wishing to modify eating patterns should adhere to each, except one. Which is the exception?

• A. Measurable
• B. Immediate
• C. Realistic
• D. Achievable

Correct answer: B

Rationale: Nutritional goals should be measurable, realistic, and achievable. They should not be immediate, as sustainable changes take time.

5. 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.

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