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. Nutrition therapy for clients with diabetes is based on:

• A. low dietary intake of sugars
• B. standardized diabetic diet plans
• C. each client’s lifestyle and preferences
• D. the client’s weight and blood glucose level

Correct answer: C

Rationale: Corrected Rationale: Nutrition therapy for clients with diabetes should be individualized to each client's lifestyle, preferences, and needs. This approach ensures that the dietary plan is sustainable and tailored to the client, leading to better adherence and improved health outcomes. Choices A and B are too general and do not account for individual differences among clients. Choice D, focusing solely on weight and blood glucose levels, overlooks other crucial aspects of a client's overall well-being and dietary requirements in diabetes management.

3. Poor nutrition results in delayed eruption and exfoliation of deciduous teeth and increased dental caries. Increased caries susceptibility in at-risk children may be related to changes in salivary composition caused by malnutrition.

• A. Both statements are true
• B. Both statements are false
• C. The first statement is true; the second is false
• D. The first statement is false; the second is true

Correct answer: A

Rationale: Both statements are true. Poor nutrition can affect tooth development and increase the risk of dental caries in children.

4. Dental hygienists are in a key position to assess and detect signs and symptoms of systemic disease because more than one third of the patients treated in a dental office frequently do not interact with a general health care provider.

• A. Both the statement and the reason are correct and related
• B. Both the statement and the reason are correct but are not related
• C. The statement is correct, but the reason is not correct
• D. The statement is not correct, but the reason is correct

Correct answer: A

Rationale: Dental hygienists often see patients more regularly than general healthcare providers, allowing them to identify systemic issues early.

5. Diet therapy for Rudy, who has acute renal failure is low-protein, low potassium and low sodium. The nutrition instructions should include:

• A. Recommend protein of high biologic value like eggs, poultry and lean meats
• B. Encourage client to include raw cucumbers, carrot, cabbage, and tomatoes
• C. Allowing the client cheese, canned foods and other processed food
• D. Bananas, cantaloupe, orange and other fresh fruits can be included in the diet

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

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