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. Which topical antimicrobial is most frequently used in burn wound care?

• A. Neosporin
• B. Silver nitrate
• C. Silver sulfadiazine
• D. Sulfamylon

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

3. Which of the following is not a desirable blood lipid value?

• A. low total cholesterol
• B. high LDL
• C. high HDL
• D. low blood triglycerides

Correct answer: B

Rationale: The correct answer is B. High levels of LDL (low-density lipoprotein) cholesterol are undesirable as they are associated with an increased risk of cardiovascular disease. Therefore, low total cholesterol (choice A), high HDL (choice C), and low blood triglycerides (choice D) are considered desirable blood lipid values. Low total cholesterol is beneficial as high levels can increase the risk of heart disease. High HDL cholesterol is considered good as it helps remove LDL cholesterol from the arteries. Low blood triglycerides are also preferred as high levels are associated with an increased risk of heart disease.

4. A caregiver is teaching a parent about recommended protein intake for a toddler. Which of the following food selections is equivalent to 1 oz of protein?

• A. 2 tbsp peanut butter
• B. ½ cup peas
• C. 1 slice of bread
• D. 1 scrambled egg

Correct answer: D

Rationale: One scrambled egg is equivalent to 1 oz of protein, making it a suitable choice for a toddler's diet. A ½ cup of peas (choice B) does not provide 1 oz of protein but is still a good source of protein. 2 tbsp of peanut butter (choice A) contains more than 1 oz of protein. 1 slice of bread (choice C) typically provides less protein than 1 oz.

5. What is the most common type of kidney stone?

• A. Cystine
• B. Calcium
• C. Struvite
• D. Uric acid

Correct answer: B

Rationale: The most common type of kidney stone is calcium-based, specifically calcium oxalate. This is usually due to high calcium levels in the urine, which can be caused by dietary factors or certain metabolic disorders. Cystine stones, on the other hand, are less common and occur in individuals with a hereditary disorder leading to excessive excretion of certain amino acids. Struvite stones are often formed in response to an infection. Uric acid stones may occur in individuals who do not consume sufficient fluids or who lose too much fluid, among other factors. Therefore, while all these substances can form stones in the kidneys, calcium stones are the most common.

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