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 student lunch is the least nutritious?

• A. Ham sandwich, apple, and milk
• B. Hamburger, fries, and soft drink
• C. Macaroni and cheese, green beans, and peaches
• D. Meatloaf, broccoli, and pear slices

Correct answer: B

Rationale: The correct answer is B - 'Hamburger, fries, and soft drink' as it contains foods high in unhealthy fats, sugars, and low nutritional value. A hamburger, fries, and a soft drink are considered less nutritious compared to the other options. Choice A includes a ham sandwich, apple, and milk, which provide a balance of protein, fiber, and calcium. Choice C consists of macaroni and cheese, green beans, and peaches, offering a mix of carbohydrates, vegetables, and fruits. Choice D contains meatloaf, broccoli, and pear slices, which provide a good source of protein, vitamins, and fiber. Therefore, option B is the least nutritious among the given choices.

3. Which type of bath would you recommend for a patient experiencing pruritus?

• A. Saline
• B. Colloidal (oatmeal)
• C. Water
• D. Sodium bicarbonate

Correct answer: B

Rationale: The best choice for a pruritus (itching) patient is a colloidal (oatmeal) bath, as it is known for its soothing effect on itchy, irritated skin. Saline, water, and sodium bicarbonate baths may not provide the same level of relief for pruritus. The nursing care should involve comprehensive assessments and appropriate interventions to optimize patient outcomes. In this case, a colloidal bath is the most suitable intervention for a patient experiencing pruritus.

4. A client with cirrhosis and ascites is being cared for by a nurse. Which of the following interventions should the nurse include in the plan of care?

• A. Decrease the client's fluid intake.
• B. Increase the client's saturated fat intake.
• C. Increase the client's sodium intake.
• D. Decrease the client's carbohydrate intake.

Correct answer: D

Rationale: In a client with cirrhosis and ascites, decreasing carbohydrate intake is essential as it helps reduce the production of ascitic fluid. Excess carbohydrates can lead to fluid retention. Choices A, B, and C are incorrect. Decreasing fluid intake can worsen dehydration, increasing saturated fat intake is not recommended due to its impact on liver health, and increasing sodium intake can worsen fluid retention and exacerbate ascites in these clients.

5. Mang Caloy is scheduled to have a hemorrhoidectomy, after the operation, you would expect that the client’s position post operatively will be:

• A. Knee chest position
• B. Side lying position
• C. Sims position
• D. Genopectoral position

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

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