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 priority nursing diagnosis for a client with major depression is:

• A. Altered nutrition
• B. Altered thought process
• C. Self care deficit
• D. Risk for injury

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 healthcare professional is preparing to remove a client’s clogged NG tube prior to re-inserting a new tube. Which of the following actions should the healthcare professional take first?

• A. Assist the client in blowing their nose.
• B. Ask the client to take a deep breath and hold it.
• C. Pinch the proximal end of the tube.
• D. Disconnect the tube from the suction source.

Correct answer: D

Rationale: Correct Answer: Disconnecting the tube from the suction source is the first step in safely removing a clogged NG tube. This action helps prevent any suction-related complications and ensures a smooth transition when removing the tube. Choice A, assisting the client to blow their nose, is not necessary in this situation. Choice B, asking the client to take a deep breath and hold it, is unrelated to the process of removing a clogged NG tube. Choice C, pinching the proximal end of the tube, should only be done after disconnecting the tube from the suction source to prevent the contents from leaking.

4. What is the primary function of a written nursing care plan?

• A. Evaluates whether nursing care goals have been achieved
• B. Ensures the provision of quality nursing care
• C. Assists in selecting the appropriate nursing interventions
• D. Facilitates the creation of a nursing diagnosis

Correct answer: D

Rationale: A written nursing care plan fundamentally serves to facilitate the development of a nursing diagnosis. This procedure involves analyzing patient data and identifying health problems that nurses can address independently. This analysis then aids in determining the most appropriate nursing interventions for the identified health issues. Although evaluating the achievement of nursing care goals is an important aspect, it is not the primary function of a nursing care plan. Similarly, while delivering quality nursing care is crucial, it is a broader concept that includes many other facets beyond just the initial nursing diagnosis and interventions.

5. You notice that Miss Kate, a bread vendor, receives and changes money, then holds the bread without washing her hands. As a nurse, what should you say to Miss Kate?

• A. Miss, don't touch the bread, I'll be the one to pick it up.
• B. Miss, please wash your hands before you pick up the bread.
• C. Miss, use a pick-up forceps when picking up the bread.
• D. Miss, your hands are dirty, I guess I'll try another bread shop.

Correct answer: B

Rationale: The correct answer is B, as it emphasizes the importance of hygiene in food handling, which is crucial to prevent the spread of germs and diseases. The other options do not address the root of the issue, which is the unhygienic handling of food. Option A avoids direct confrontation but does not educate the vendor on proper hygiene. Option C, although it suggests a hygienic method, may not be practical or available in all situations. Option D is an avoidance strategy rather than a way to address the problem.

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