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. Mr. CKK is unconscious and was brought to the E.R. Who among the following can give consent for CKK's operation?

• A. Doctor
• B. Nurse
• C. Next of Kin
• D. The Patient

Correct answer: A

Rationale: In the scenario described, when a patient is unconscious and unable to provide consent, the responsibility usually falls on the physician to make decisions regarding the patient's treatment, including obtaining consent for an operation. While nurses play a crucial role in patient care, they typically do not have the authority to provide consent for a major procedure. The next of kin may be consulted for input, but the ultimate decision-making authority lies with the physician. The patient, being unconscious, is unable to provide consent in this situation.

3. While a team effort is necessary in the operating room (OR) for efficient and quality patient care delivery, the number of people in the room should be limited for infection control purposes. Which roles comprise this team?

• A. Surgeon, anesthesiologist, scrub nurse, radiologist, orderly
• B. Surgeon, assistants, scrub nurse, circulating nurse, anesthesiologist
• C. Surgeon, assistant surgeon, anesthesiologist, scrub nurse, pathologist
• D. Surgeon, assistant surgeon, anesthesiologist, intern, scrub nurse

Correct answer: B

Rationale: The roles typically present in an operating room team include the surgeon, assistants (which may include an assistant surgeon), scrub nurse, circulating nurse, and anesthesiologist. These roles are directly involved in the operation and patient care. Choice B is correct. Choice A includes a radiologist and an orderly, who are not typically part of the immediate surgical team in the OR. Choice C includes a pathologist, who usually works in a laboratory outside of the OR. Choice D includes an intern, who may or may not be part of the team, depending on the specific circumstances and hospital policy. These explanations make choices A, C, and D incorrect.

4. A woman who has been following a vegan diet may need ____ supplements.

• A. vitamin C and vitamin A
• B. vitamin D and vitamin B12
• C. vitamin E and K
• D. vitamin D and niacin

Correct answer: B

Rationale: The correct answer is B: vitamin D and vitamin B12. Vegans may need to supplement vitamin D and B12 as these nutrients are mainly found in animal products. While choices A, C, and D are essential vitamins, they are not typically lacking in a vegan diet. Vitamin C can be obtained from various plant sources, vitamin A can be derived from beta-carotene in plants, and vitamin E and K are also found in plant-based foods. Niacin, although important, can be sourced from plant-based sources and is not a common deficiency in vegan diets.

5. A client reports having difficulty losing weight. Which of the following responses by the nurse is appropriate?

• A. Eat small portions of high-calorie foods first.
• B. Set a goal, and you will be able to attain it.
• C. It is helpful to self-monitor your eating.
• D. Taste food while cooking to help curb your appetite.

Correct answer: C

Rationale: The correct answer is C: 'It is helpful to self-monitor your eating.' Self-monitoring dietary intake is an evidence-based strategy that enhances awareness and accountability, making it an effective approach for weight management. Choice A is incorrect as focusing on high-calorie foods first may not be the most effective strategy for weight loss. Choice B is too general and lacks actionable advice. Choice D, tasting food while cooking, does not directly address the client's difficulty in losing weight and is not a proven method for weight management.

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