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 providing teaching to a group of parents of newborns who are planning to formula feed. Which of the following statements by a parent indicates a need for further teaching?

• A. "I will give formula to my baby at room temperature."
• B. "I will ensure my baby's feeds last 10 to 15 minutes."
• C. "I will burp my baby halfway through each feeding."
• D. "I will watch for signs my baby is full and stop the feeding."

Correct answer: B

Rationale: The correct answer is, "I will ensure my baby's feeds last 10 to 15 minutes." This statement indicates a need for further teaching because it suggests a strict time limit for feedings, which may not be appropriate for a newborn. Newborns should be allowed to feed as long as they want, typically around 20-30 minutes per breast if breastfeeding, or on-demand with formula. Choices A, C, and D demonstrate proper feeding practices such as feeding at room temperature, burping halfway through each feeding, and watching for signs of fullness to stop the feeding, which are all appropriate responses by a parent of a formula-fed newborn.

3. A nurse is caring for a client who has a new prescription for a low-sodium diet. The client's family has requested to bring in some of the client's favorite foods. Which of the following food items should the nurse tell the family members to omit?

• A. Boiled rice
• B. Flat bread
• C. Broiled fish fillet
• D. Pickled vegetables

Correct answer: D

Rationale: The correct answer is 'Pickled vegetables.' Pickled vegetables are high in sodium due to the pickling process, making them unsuitable for a low-sodium diet. Boiled rice, flat bread, and broiled fish fillet are generally lower in sodium compared to pickled vegetables and can be included in a low-sodium diet. Therefore, the nurse should advise the family to omit pickled vegetables to adhere to the client's dietary restrictions.

4. A mother asks about healthy snacks for her three children under 4 years old. All are wise choices the dental hygienist can recommend, except one. Which is the exception?

• A. Low-fat milk or yogurt
• B. Whole-grain cereals
• C. Raw vegetable sticks
• D. Nuts and seeds

Correct answer: D

Rationale: Nuts and seeds pose a choking hazard for children under 4 years old, making them an unsafe snack choice for young children. While low-fat milk or yogurt, whole-grain cereals, and raw vegetable sticks are healthy snack options suitable for children under 4 years old, nuts and seeds should be avoided due to the risk of choking, especially in young children who may not have fully developed chewing abilities.

5. Amy is a 68-year-old patient who has rheumatoid arthritis affecting her hands and feet. Which substance has been shown to reduce joint tenderness and improve mobility in some people with this type of arthritis?

• A. Alfalfa Tea
• B. Cod Liver Oil
• C. Lecithin
• D. Fish Oil

Correct answer: D

Rationale: Fish oil has been identified as a substance that can help reduce joint tenderness and improve mobility in individuals with rheumatoid arthritis, as it is rich in omega-3 fatty acids. Omega-3 fatty acids have anti-inflammatory properties that can help alleviate the symptoms of rheumatoid arthritis. On the other hand, while Alfalfa Tea, Cod Liver Oil, and Lecithin have various health benefits, there isn't substantial evidence to suggest that they can improve conditions associated with rheumatoid arthritis.

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