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. A nurse is teaching a client about complete and incomplete proteins. Which of the following foods should the nurse include in the teaching as an incomplete protein?

• A. 4 oz chickpeas
• B. 2 poached eggs
• C. 2 oz cheddar cheese
• D. 4 oz salmon fillet

Correct answer: A

Rationale: The correct answer is A: 4 oz chickpeas. Chickpeas are considered an incomplete protein because they lack one or more essential amino acids required by the body. Incomplete proteins do not provide all essential amino acids in sufficient quantities. Choice B, 2 poached eggs, is a complete protein source because eggs contain all essential amino acids. Choice C, 2 oz cheddar cheese, is also a complete protein as it contains all essential amino acids. Choice D, 4 oz salmon fillet, is another complete protein source as fish typically provide all essential amino acids needed by the body.

3. What is the most common nutritional disorder for the older adult?

• A. Obesity
• B. Underweight
• C. Vitamin deficiency
• D. Dehydration

Correct answer: A

Rationale: The correct answer is A: Obesity. Among older adults, obesity is the most common nutritional disorder. This is often attributed to reduced physical activity levels and changes in metabolism that occur with aging. Choice B (Underweight) is less common among older adults as compared to obesity. While choices C (Vitamin deficiency) and D (Dehydration) are important nutritional issues, they are generally not as prevalent as obesity in the older adult population.

4. What is the approximate energy value of alcohol?

• A. 3 kcal/g
• B. 7 kcal/g
• C. 10 kcal/g
• D. 25 kcal/g

Correct answer: B

Rationale: The correct answer is B: 7 kcal/g. Alcohol provides approximately 7 kilocalories per gram, making it a significant source of energy or 'empty calories' in the diet that do not contain any nutrients. 'Empty calories' refer to the calorie content without the presence of essential nutrients. Choices A, C, and D are incorrect. The energy values of 3 kcal/g, 10 kcal/g, and 25 kcal/g are not accurate for alcohol; instead, they may pertain to other nutrients such as carbohydrates (approximately 4 kcal/g), fats (approximately 9 kcal/g), and oils (approximately 9 kcal/g).

5. What should Mrs. Smith do to increase her HDL levels, as advised by the nurse?

• A. Monitor her blood glucose levels
• B. Quit smoking
• C. Control her blood pressure
• D. Take fish oil supplements

Correct answer: B

Rationale: The correct answer is 'Quit smoking.' Smoking has been shown to lower HDL (High-Density Lipoprotein) levels, and quitting can help to improve these levels. HDL is often referred to as 'good cholesterol' because it helps to remove other forms of cholesterol from the bloodstream, reducing the risk of heart disease. While monitoring blood glucose levels, controlling blood pressure, and taking fish oil supplements can contribute to overall health and wellbeing, they do not directly increase HDL levels in the same way that quitting smoking does. Therefore, quitting smoking is the most effective way for Mrs. Smith to increase her HDL levels as advised by the nurse.

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