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. What is the digestive action of lipase?

• A. It breaks down carbohydrates
• B. It breaks down proteins
• C. It breaks down lipids
• D. It aids in fat digestion

Correct answer: C

Rationale: Lipase is an enzyme that specifically breaks down lipids (fats) during the process of digestion, converting them into fatty acids and glycerol. This is why option C is the correct answer. Although option D is partially correct, it's less specific than option C. Lipase does not break down carbohydrates or proteins, so options A and B are incorrect.

3. This special form is used when the patient is admitted to the unit. The nurse completes the information in this record particularly his/her basic personal data, current illness, previous health history, health history of the family, emotional profile, environmental history as well as physical assessment together with nursing diagnosis on admission. What do you call this record?

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

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. A client with frequent kidney stones is receiving dietary teaching from a nurse. Which of the following instructions should the nurse include?

• A. Limit your intake of dairy products.
• B. Increase your consumption of protein-rich foods.
• C. Avoid eating tree nuts, such as almonds.
• D. Take a vitamin C supplement twice daily.

Correct answer: A

Rationale: The correct answer is to instruct the client to limit their intake of dairy products. Dairy products are high in calcium and can contribute to kidney stone formation in susceptible individuals. Increasing protein intake may lead to higher excretion of calcium, which can exacerbate kidney stone formation. While tree nuts are high in oxalates, which can contribute to kidney stone formation, it is not the primary concern in this case. Vitamin C supplements can increase oxalate levels in the urine, potentially increasing the risk of kidney stone formation, so it should not be recommended.

5. Symptoms of irritable bowel syndrome are most likely associated with disturbed defecation, bloating, and _____.

• A. rectal bleeding
• B. abdominal pain
• C. rectal fissures
• D. esophageal paralysis

Correct answer: B

Rationale: Abdominal pain is a common symptom of irritable bowel syndrome (IBS), along with bloating and changes in bowel habits. Rectal bleeding (choice A) is more commonly associated with conditions like inflammatory bowel disease or colorectal cancer. Rectal fissures (choice C) may cause rectal bleeding but are not typically considered a core symptom of IBS. Esophageal paralysis (choice D) is unrelated to the symptoms of IBS, which primarily affect the lower gastrointestinal tract.

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