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 of the following questions illustrates the group role of encourager?

• A. What were you saying?
• B. Who wants to respond next?
• C. Where do you go from here?
• D. Why haven’t we heard from you?

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

3. Which test is used to monitor the degree of blood glucose control over a long period?

• A. Glucose tolerance test
• B. Glycated hemoglobin level
• C. Self-monitoring of blood glucose
• D. 24-hour urinary glucose excretion

Correct answer: B

Rationale: The correct answer is B, glycated hemoglobin level. The glycated hemoglobin (HbA1c) test measures the average blood glucose levels over the past 2-3 months, providing a long-term picture of glucose control. Choice A, the glucose tolerance test, measures how well your body processes glucose but is not specifically for long-term monitoring. Choice C, self-monitoring of blood glucose, involves daily testing by individuals, providing immediate rather than long-term information. Choice D, 24-hour urinary glucose excretion, measures the amount of glucose excreted in the urine over 24 hours and is not typically used for long-term monitoring of blood glucose control.

4. What are the potential consequences of damage to the stomach?

• A. Reduced digestion of carbohydrates
• B. Inability to produce or secrete bile
• C. Inability to produce or secrete gastric acid
• D. Increased ability to produce or secrete intrinsic factor

Correct answer: C

Rationale: Damage to the stomach can lead to a reduced ability to produce gastric acid (Choice C) and intrinsic factor, the latter of which is crucial for vitamin B12 absorption (Choice D). That's why these two choices are correct. The stomach doesn't play a direct role in the digestion of carbohydrates (Choice A) as this process primarily occurs in the small intestine with the help of pancreatic enzymes. Similarly, bile is produced by the liver and stored in the gallbladder, not the stomach, hence stomach damage wouldn't lead to an inability to produce or secrete bile (Choice B).

5. What sensation is used as a gauge so that patients with ileostomy can determine how often their pouch should be drained?

• A. Sensation of taste
• B. Sensation of pressure
• C. Sensation of smell
• D. Urge to defecate

Correct answer: B

Rationale: The correct answer is B: Sensation of pressure. Patients with ileostomy can determine how often their pouch should be drained by feeling the sensation of pressure. This is important as it helps prevent leakage or overflow of the pouch. The sensation of taste (choice A) and smell (choice C) are not typically used as gauges for draining the pouch in ileostomy patients. The urge to defecate (choice D) is not relevant in this context as patients with ileostomy do not pass stool through the rectum.

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