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 gluten-free food choice would be most appropriate for a patient with celiac disease?

• A. Scalloped potatoes
• B. Oatmeal
• C. Eggs
• D. Tortillas

Correct answer: C

Rationale: Eggs are a safe food choice for individuals with celiac disease as they are naturally gluten-free. Scalloped potatoes often contain flour in the sauce, which might contain gluten. Oatmeal can be a subject of debate due to possible cross-contamination during processing, so it might not be safe unless labeled gluten-free. Tortillas are typically made from wheat flour containing gluten, but gluten-free versions are available. However, eggs are universally gluten-free, making them the best choice for individuals with celiac disease.

3. You are caring for Conrad who has a brain tumor and increased Intracranial Pressure (ICP). Which intervention should you include in your plan to reduce ICP?

• A. Administer bowel softener
• B. Position Conrad with his head turned toward the side of the tumor
• C. Provide sensory stimulation
• D. Encourage coughing and deep breathing

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. Scurvy is caused by a deficiency of ascorbic acid (Vitamin C) because ascorbic acid is required for collagen synthesis. Is this statement true or false?

• A. TRUE
• B. FALSE
• C. Not applicable
• D. Not applicable

Correct answer: A

Rationale: The statement is accurate. Scurvy is indeed caused by a deficiency in ascorbic acid, which is another name for Vitamin C. This vitamin plays a crucial role in the synthesis of collagen, a protein that helps in the formation and strength of skin, blood vessels, tissues, and bones. When the body lacks Vitamin C, it cannot produce enough collagen, leading to symptoms associated with scurvy such as bleeding gums and weakened immunity. The choice 'False' is incorrect because it contradicts the proven medical and scientific understanding of the causes of scurvy. Choices 'C' and 'D' are marked as 'Not applicable' because the question only requires a true or false answer.

5. What symptoms would most likely be associated with a transient ischemic attack?

• A. confusion and difficulty speaking
• B. headache and blurred vision
• C. chest pain and pressure
• D. claudication and peripheral edema

Correct answer: A

Rationale: The correct answer is A: confusion and difficulty speaking. These symptoms are commonly associated with a transient ischemic attack (TIA), which is a temporary blockage of blood flow to the brain. Choice B, headache and blurred vision, are more indicative of other conditions such as migraines or eye problems. Choice C, chest pain and pressure, are more characteristic of cardiac issues like a heart attack. Choice D, claudication and peripheral edema, are typical of peripheral arterial disease and not typically seen in TIAs.

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