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. A nurse is caring for a client who is receiving parenteral nutrition. Which of the following findings indicates the therapy is effective?

• A. Client has soft, formed bowel movements.
• B. Client’s mucous membranes are pink.
• C. Client reports ability to complete ADLs.
• D. Client’s blood glucose level is within the expected reference range.

Correct answer: D

Rationale: The correct answer is D because having a blood glucose level within the expected reference range indicates that parenteral nutrition is effectively meeting the client's nutritional needs. Choices A, B, and C are incorrect because soft, formed bowel movements, pink mucous membranes, and the ability to complete activities of daily living do not directly reflect the effectiveness of parenteral nutrition therapy.

3. What is the function of villi and microvilli in the GI tract?

• A. produce bile
• B. kill bacteria
• C. produce vitamin K
• D. increase the surface area for absorption

Correct answer: D

Rationale: Villi and microvilli in the GI tract serve to increase the surface area of the small intestine, aiding in the absorption of nutrients into the bloodstream. Choices A, B, and C are incorrect as villi and microvilli are primarily involved in enhancing absorption, not in producing bile, killing bacteria, or producing vitamin K.

4. A child with ear problem should be assessed for the following, EXCEPT:

• A. is there any fever?
• B. Ear discharge
• C. If discharge is present for how long?
• D. Ear pain

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.

5. Why are blood glucose levels high in type 1 diabetes?

• A. The urinary excretion of glucose is impaired
• B. The lean body mass is metabolized to produce glucose via gluconeogenesis
• C. The absorption of glucose from the gastrointestinal tract is more efficient
• D. There is insufficient insulin to facilitate the transport of glucose into the cells

Correct answer: D

Rationale: In type 1 diabetes, the body's immune system destroys the beta cells in the pancreas that produce insulin. This leads to an insufficient amount of insulin, which is required to facilitate the transport of glucose into the cells. Consequently, blood glucose levels remain high. The other options are incorrect. Option A is incorrect because urinary excretion of glucose does not directly contribute to blood glucose levels. Option B is incorrect because, while gluconeogenesis does produce glucose, it is not the cause of high glucose levels in type 1 diabetes. Option C is incorrect because absorption efficiency of glucose from the gastrointestinal tract does not affect the amount of insulin available to transport glucose into cells.

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