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. What is the term for a barrier that prevents the normal emptying of stomach contents into the duodenum?

• A. Dumping syndrome
• B. Gastritis
• C. Gastric outlet obstruction
• D. Hypochlorhydria

Correct answer: C

Rationale: Gastric outlet obstruction refers to a condition where the opening between the stomach and the duodenum is blocked, preventing the normal passage of food. This is why choice 'C' is correct. 'A: Dumping syndrome' is incorrect because it is a condition where stomach contents move too quickly through the small intestine, not a barrier preventing emptying. 'B: Gastritis' is inflammation of the stomach lining, not a blockage of the outlet. 'D: Hypochlorhydria' refers to low stomach acid, which may affect digestion but does not create a physical barrier blocking the outlet of the stomach.

3. In persons who are obese, weight reduction can improve such CHD risk factors as hypertension, blood lipid abnormalities, and?

• A. inflammation
• B. insulin resistance
• C. gastrointestinal motility disorders
• D. damage from cigarette smoking

Correct answer: B

Rationale: Weight reduction in obese individuals can improve insulin resistance, a key factor in reducing the risk of coronary heart disease and type 2 diabetes.

4. What type of drug therapy is typically administered immediately after a heart attack?

• A. Antilipemic drugs
• B. Corticosteroids
• C. Diuretics
• D. Thrombolytic drugs

Correct answer: D

Rationale: Thrombolytic drugs are typically administered immediately after a heart attack to dissolve the clot blocking the coronary artery and restore blood flow to the heart muscle. Antilipemic drugs are used to lower lipid levels and prevent atherosclerosis, but they are not typically administered immediately after a heart attack. Corticosteroids are used to reduce inflammation and suppress the immune response, which are not immediate concerns after a heart attack. Diuretics are used to reduce fluid build-up and lower blood pressure, but these are not the primary concerns immediately following a heart attack.

5. What primarily determines the Dietary Reference Intake (DRI) for protein?

• A. Intake of fatty acids
• B. Gender
• C. Height
• D. Body weight

Correct answer: D

Rationale: The Dietary Reference Intake (DRI) for protein is primarily determined by an individual's body weight. This is because the body's protein requirement is proportionate to its size, which is generally reflected in the body weight. Therefore, choice D is correct. Choices A, B, and C are incorrect: While factors such as fatty acid intake, gender, and height can influence an individual's overall nutritional needs, they do not directly determine the DRI for protein.

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