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. The breakdown in teamwork is often times a failure in:

• A. Electricity
• B. Inadequate supply
• C. Leg work
• D. Communication

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

3. A nurse is providing preventative information to a group of parents with toddlers about choking. Which food item should the nurse recommend for this age group?

• A. Banana slices
• B. Popcorn
• C. Hot dogs
• D. Carrot sticks

Correct answer: A

Rationale: Banana slices are the most suitable food option for toddlers to prevent choking. Toddlers are at a higher risk of choking due to their small airways and developing chewing abilities. Banana slices are soft, easy to chew, and less likely to cause choking compared to other options. Popcorn and hot dogs are common choking hazards for young children due to their shape and texture. While carrot sticks may be a healthy choice, they can also pose a choking risk due to their hardness and shape. Therefore, recommending banana slices to parents of toddlers is the safest choice to prevent choking incidents, making choice 'A' the correct answer. Choices 'B', 'C', and 'D' are incorrect because they can potentially cause choking in toddlers.

4. Electrolytes create _____, which is caused by water following electrolytes within or between cells.

• A. energy
• B. active transport
• C. passive diffusion
• D. osmotic pressure

Correct answer: D

Rationale: Osmotic pressure is the force that drives water movement across cell membranes due to the presence of electrolytes, helping to balance fluid levels in the body. Choice A, 'energy,' is incorrect as electrolytes do not directly create energy. Choice B, 'active transport,' refers to the movement of molecules across a cell membrane requiring energy, not the movement of water. Choice C, 'passive diffusion,' is the process by which substances move from an area of higher concentration to lower concentration, not related to the movement of water following electrolytes.

5. Cariogenic foods and beverages, which are fermentable carbohydrates that can be metabolized by oral bacteria, reduce salivary pH to what critical level?

• A. 5
• B. 5.5
• C. 6
• D. 6.5

Correct answer: B

Rationale: Cariogenic foods and beverages lower the pH level in the mouth to below 5.5. This is a critical threshold, as it is the point at which enamel begins to demineralize, increasing the risk of dental caries. Therefore, options 'A', 'C', and 'D' are incorrect. Although a pH level of 5, as suggested by option 'A', would indeed lead to demineralization, it's not the threshold value. The pH levels suggested by options 'C' and 'D' (6 and 6.5, respectively) are higher than the critical value of 5.5, which means they would not initiate enamel demineralization and the subsequent risk of dental caries.

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