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. What are sheets/forms that provide an efficient and time-saving way to record information that must be obtained repeatedly at regular and/or short intervals of time? This does not replace progress notes; instead, it records information on vital signs, intake and output, treatment, postoperative care, postpartum care, and diabetic regimen, etc. These are used whenever specific measurements or observations need to be documented repeatedly. What is this?

• A. Nursing Kardex
• B. Graphic Flow Sheets
• C. Discharge Summary
• D. Medicine and Treatment Record

Correct answer: A

Rationale: The correct answer is A, Nursing Kardex. Nursing Kardex is a tool used for documenting essential patient information that needs to be recorded repeatedly at regular intervals. It includes vital signs, intake and output, treatment details, postoperative care, postpartum care, and diabetic regimen. This tool is efficient and time-saving for healthcare professionals. Choice B, Graphic Flow Sheets, may be used for visual representation of patient data but is not specifically designed for repeated documentation of essential information. Choice C, Discharge Summary, is a document outlining the patient's care and condition at the time of discharge, not for repeated recording of ongoing data. Choice D, Medicine and Treatment Record, focuses more on specific medications and treatments rather than a comprehensive recording of various patient data needed at regular intervals.

3. A nurse is preparing to teach a group of clients about vitamins and minerals. The nurse should include in the teaching that which of the following minerals is necessary for the transmission of nerve impulses?

• A. Phosphorus
• B. Calcium
• C. Chloride
• D. Zinc

Correct answer: B

Rationale: Corrected Question: A nurse is preparing to teach a group of clients about vitamins and minerals. The nurse should include in the teaching that which of the following minerals is necessary for the transmission of nerve impulses? Correct Answer: Calcium Rationale: Calcium is crucial for nerve transmission, muscle contraction, and blood clotting. It plays a vital role in the proper functioning of the nervous system. Phosphorus is important for bone health and energy metabolism, not nerve impulse transmission. Chloride is an electrolyte important for fluid balance but not directly involved in nerve impulse transmission. Zinc is essential for immune function and wound healing but not specifically required for nerve impulse transmission.

4. An elderly man is hospitalized with a diagnosis of malnutrition three months following his wife's death. What risk factor for malnutrition does this scenario illustrate?

• A. A history of chronic illness
• B. Depression or social isolation
• C. Age
• D. Impaired mobility

Correct answer: B

Rationale: This scenario illustrates depression or social isolation as a risk factor for malnutrition. After the death of his wife, the elderly man may have experienced depression or social isolation, which can lead to decreased food intake and poor nutritional status. Although age, chronic illness, and impaired mobility can also contribute to malnutrition, they are not the primary factors described in this scenario. The history of chronic illness (Choice A) and impaired mobility (Choice D) were not mentioned in the scenario, and while age (Choice C) is a factor, it's not the main factor depicted in this case.

5. A client with a body mass index of 28 is seeking dietary advice. Which of the following actions should the nurse take?

• A. Encourage the client to continue their current daily caloric intake.
• B. Recommend a total fiber intake of 12g per day.
• C. Advise the client to add 500 calories per day to their diet.
• D. Refer the client to a weight-loss support group.

Correct answer: D

Rationale: Referring the client to a weight-loss support group is the most appropriate action for a client with a body mass index of 28. This action can provide the necessary support, guidance, and motivation to help the client achieve their weight loss goals. Encouraging the client to continue their current daily caloric intake (Choice A) may not address the need for weight loss. Recommending a total fiber intake of 12g per day (Choice B) is important for overall health but may not directly address weight loss. Advising the client to add 500 calories per day to their diet (Choice C) would not be beneficial for weight loss in this scenario.

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