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. Churns chyme and has an environment of pH2; holds 4-6 cups of food:

• A. stomach
• B. pancreas
• C. large intestine
• D. small intestine

Correct answer: A

Rationale: The stomach churns food into chyme and has a highly acidic environment (pH 2) to aid in the digestion of proteins and other nutrients.

3. Which type of bread, cereal, or pasta would most likely be recommended for a patient on a fat-restricted diet?

• A. popcorn
• B. fried rice
• C. English muffins
• D. granola

Correct answer: C

Rationale: English muffins would be the most suitable option for a patient on a fat-restricted diet. They are typically lower in fat compared to fried rice, granola, and popcorn with butter. Popcorn, fried rice, and granola are higher in fat content and may not be the best choice for individuals on a fat-restricted diet.

4. The oral cavity is the site of a wide variety of systemic disease manifestations due to:

• A. Rapid cellular turnover
• B. Constant attack by microorganisms
• C. Trauma-intense environment
• D. All of the above

Correct answer: D

Rationale: The oral cavity is indeed the site of various systemic disease manifestations due to multiple factors. Firstly, the rapid cellular turnover in the oral mucosa makes it susceptible to diseases. Secondly, the constant presence of microorganisms in the oral cavity contributes to the development of systemic diseases. Finally, the oral cavity being a trauma-intense environment further increases the risk of systemic manifestations. Therefore, all the provided options - rapid cellular turnover, constant attack by microorganisms, and a trauma-intense environment - play a role in making the oral cavity a site for various systemic diseases. Hence, the correct answer is 'All of the above.' Choices A, B, and C are incorrect individually as they each represent only one aspect of why the oral cavity is prone to systemic disease manifestations, whereas the correct answer encompasses all these factors.

5. The nurse is caring for an infant whose parent reports the infant takes a bottle to go to sleep. What should the nurse instruct to prevent baby bottle tooth decay?

• A. Water
• B. Milk
• C. Iron-fortified formula
• D. Unsweetened fruit juice

Correct answer: A

Rationale: The correct answer is A, Water. Water is recommended to prevent baby bottle tooth decay caused by sugary substances present in milk, formula, or fruit juice. Water does not contain sugars that can contribute to tooth decay, unlike the other options. Milk, formula, and unsweetened fruit juice can all lead to tooth decay if the baby falls asleep with them in their mouth, as the sugars can linger on the teeth and cause decay over time. Iron-fortified formula, although beneficial for the infant's nutrition, still contains sugars that can be harmful to the teeth.

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