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. The nurse cares for a hospitalized adolescent with the diagnosis of anorexia nervosa. Which nursing goal is a priority for this client?

• A. Encourage effective coping skills
• B. Restore normal eating habits
• C. Stop weight loss or restore weight
• D. Promote realistic self-image

Correct answer: C

Rationale: In the treatment of anorexia nervosa, stopping weight loss or restoring weight is a critical priority. This helps address the immediate health risks associated with severe malnutrition and supports the client's physical well-being. Encouraging effective coping skills, restoring normal eating habits, and promoting a realistic self-image are essential aspects of treatment but may come later in the care plan once the immediate risk of severe weight loss has been addressed.

3. The most significant factor that might affect the nurse’s care for the psychiatric patient is:

• A. Nurse’s own beliefs and attitude about the mentally ill
• B. Amount of experience he has with psychiatric clients
• C. Her abilities and skill to care for the psychiatric clients
• D. Her knowledge in dealing with the psychiatric clients

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

4. A client receiving total parenteral nutrition (TPN) suddenly develops tremors, dizziness, and diaphoresis. The client said, 'I feel weak and the bag was empty.' Which is the most likely complication the client is currently experiencing?

• A. Fluid volume overload
• B. Sepsis
• C. Hyperglycemia
• D. Hypoglycemia

Correct answer: D

Rationale: The client experiencing tremors, dizziness, diaphoresis, weakness, and stating that the TPN bag is empty is likely experiencing hypoglycemia. Hypoglycemia can occur when the TPN infusion suddenly stops, leading to a rapid drop in blood sugar levels. Symptoms of hypoglycemia include tremors, dizziness, diaphoresis, and weakness. Choices A, B, and C are incorrect as the symptoms presented are more consistent with hypoglycemia rather than fluid volume overload, sepsis, or hyperglycemia.

5. A client with cholecystitis is being taught about required dietary modifications. Which of the following foods is appropriate for the client's diet?

• A. Creamed chicken
• B. Roast turkey
• C. Ice cream
• D. Macaroni and cheese

Correct answer: B

Rationale: Roast turkey is the most appropriate choice for a client with cholecystitis. Foods that are high in fat content, like creamed chicken, ice cream, and macaroni and cheese, should be avoided in cholecystitis as they can exacerbate symptoms due to the reduced ability of the gallbladder to process fats. Roast turkey is a leaner option that is better tolerated by individuals with cholecystitis.

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