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 happens when Mrs. Guevarra, a nurse, delegates aspects of the client's care to the nurse-aide, an unlicensed staff member?

• A. Mrs. Guevarra makes the assignment to instruct the staff member
• B. Mrs. Guevarra is assigning the responsibility to the aide but not the accountability for those tasks
• C. Mrs. Guevarra does not need to directly supervise or evaluate the aide
• D. Mrs. Guevarra must know how to perform the task being delegated

Correct answer: C

Rationale: The correct answer is C. While it is true that Mrs. Guevarra is delegating tasks to the nurse-aide, she does not necessarily have to directly supervise or evaluate the aide. She still retains the overall accountability for the care of the client, but direct supervision of the aide is not a requirement for delegation. Choice A is incorrect because the primary purpose of delegation is not instruction. Choice B is also incorrect because although Mrs. Guevarra is delegating tasks, she still retains accountability for those tasks. Finally, choice D is incorrect because the ability to perform the task being delegated is not a requirement for the delegator; the delegatee should have the necessary skills and knowledge to perform the delegated tasks.

3. What is the most likely demonstration of cardiac cachexia?

• A. Decreased physical activity
• B. Weight loss and tissue wasting
• C. Poor urine output and tissue edema
• D. Cardiac arrhythmia and wet lung sounds

Correct answer: B

Rationale: Cardiac cachexia is a condition characterized by severe weight loss and tissue wasting. This typically occurs in patients suffering from heart failure due to an increased energy expenditure and reduced appetite, which is why choice B is the correct answer. The other choices are incorrect as they do not accurately describe the symptoms of cardiac cachexia. Decreased physical activity (choice A) can be a result of many conditions, not specifically cardiac cachexia. Poor urine output and tissue edema (choice C) are more indicative of kidney problems rather than cardiac cachexia. Finally, cardiac arrhythmia and wet lung sounds (choice D) are symptoms related to other cardiac conditions, not specifically to cardiac cachexia.

4. What nutrition-related side effect is most likely to occur after head and neck surgery for cancer treatment?

• A. Aspiration
• B. Acid reflux
• C. Dumping syndrome
• D. Diarrhea

Correct answer: A

Rationale: The most likely nutrition-related side effect after head and neck surgery for cancer treatment is aspiration. This is due to changes in swallowing mechanics, which can cause food or liquids to be inhaled into the lungs. While acid reflux, dumping syndrome, and diarrhea are potential side effects related to nutrition, they are not as directly connected to head and neck surgery. Acid reflux is more often related to issues with the lower esophageal sphincter, dumping syndrome is typically a complication of gastric surgery, and diarrhea can have various causes, including certain medications or gastrointestinal illnesses.

5. A client needs to increase his protein intake and enjoys certain foods. Which of the following foods should the nurse recommend as the best source of protein among these suggestions?

• A. Yams
• B. Eggs
• C. Chicken
• D. Peanuts

Correct answer: C

Rationale: Chicken is the best source of protein among the options provided. It is a lean source of protein and contains essential amino acids needed for the body. Eggs are also a good source of protein, but chicken typically contains more protein per serving compared to eggs. Peanuts are a good source of plant-based protein, but chicken provides a higher amount of protein and is usually leaner. Yams, while nutritious, are not a significant source of protein compared to chicken, eggs, or peanuts.

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