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. To ensure client safety before starting blood transfusions, the following are needed before the procedure can be done EXCEPT:

• A. take baseline vital signs
• B. warm the blood to room temperature for 30 minutes before administering the transfusion
• C. have two nurses verify client identification, blood type, unit number, and expiration date of blood
• D. get consent signed for blood transfusion

Correct answer: D

Rationale: To ensure client safety before starting blood transfusions, taking baseline vital signs, warming the blood to room temperature, and having two nurses verify client identification, blood type, unit number, and expiration date of blood are crucial steps. Consent for blood transfusion is required but is typically obtained before the procedure. The focus before the procedure should be on confirming the right client, blood product, and ensuring the blood is prepared correctly to minimize risks of transfusion reactions.

3. What is tocopherol?

• A. Vitamin B1
• B. Vitamin B2
• C. Vitamin B3
• D. Vitamin E

Correct answer: D

Rationale: Tocopherol is another name for Vitamin E, a fat-soluble antioxidant that helps protect cell membranes from oxidative damage. Choices A, B, and C are incorrect as tocopherol is specifically related to Vitamin E and not Vitamin B1, B2, or B3.

4. What physiological role does phosphorus play in the body?

• A. Blood clotting, transmission of nerve impulses, muscle contraction, and relaxation
• B. Calcium homeostasis, structural integrity of heart muscle
• C. No known metabolic function, caries-preventing properties
• D. ATP energy release; metabolism of fats, carbohydrates, proteins; regulates acid-base balance

Correct answer: D

Rationale: The correct answer is D. Phosphorus plays a crucial role in ATP energy release, the metabolism of fats, carbohydrates, and proteins, and regulation of acid-base balance. Choices A, B, and C are incorrect. Phosphorus is not directly involved in blood clotting, transmission of nerve impulses, muscle contraction, or calcium homeostasis. It also has known metabolic functions and is not associated with caries prevention.

5. The major determinant of a person's total cholesterol levels is the amount of cholesterol in their diet.

• A. True
• B. False
• C.
• D.

Correct answer: B

Rationale: It is false that the major determinant of a person's total cholesterol levels is the amount of cholesterol in their diet. While dietary cholesterol can have some impact on total cholesterol levels, it is not the major determinant. The amount and types of fats consumed, particularly saturated and trans fats, have a more significant impact on blood cholesterol levels. Therefore, a diet high in these types of fats can lead to high cholesterol, irrespective of the amount of dietary cholesterol consumed. This is why it is essential to maintain a balanced diet with a limited intake of saturated and trans fats.

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