Nursing Elites

1. A client with pre-dialysis end-stage kidney disease is being taught about diet. Which of the following instructions should the nurse include?

• A. Increase intake of dietary phosphorus.
• B. Eliminate foods high in protein from your diet.
• C. Reduce intake of foods high in potassium.
• D. Increase intake of sodium-containing foods.

Correct answer: C

Rationale: In pre-dialysis end-stage kidney disease, reducing intake of foods high in potassium is crucial as impaired kidney function can lead to potassium buildup in the blood, which can be dangerous. High potassium levels can cause irregular heartbeats and even cardiac arrest. Therefore, advising the client to reduce potassium-rich foods is essential to prevent complications. Choices A, B, and D are incorrect. Increasing dietary phosphorus, eliminating foods high in protein, or increasing sodium-containing foods are not appropriate recommendations for a client with pre-dialysis end-stage kidney disease as they can exacerbate the condition.

2. How many calories does one pound of fat equal?

• A. 1500 calories
• B. 2500 calories
• C. 3500 calories
• D. 5000 calories

Correct answer: C

Rationale: One pound of body fat is equivalent to approximately 3500 calories. This is a generally accepted caloric value used in nutrition and weight management. It's important to note that this is an estimation and individual variations may occur. Choice A (1500 calories), Choice B (2500 calories), and Choice D (5000 calories) are incorrect because they do not match the generally accepted caloric value of 3500 calories for one pound of body fat.

3. A patient tells the nurse “I am depressed to talk to you, leave me alone” Which of the following response by the nurse is most therapeutic?

• A. I’ll be back in an hour
• B. Why are you so depressed?
• C. I’ll seat with you for a moment
• D. Call me when you feel like talking to me

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

4. Onset frequently occurs after the age of 40.

• A. Type 1 Diabetes
• B. Type 2 Diabetes
• C.
• D.

Correct answer: B

Rationale: The correct answer is B, Type 2 Diabetes. Type 2 Diabetes commonly presents with an onset after the age of 40, although it is now also seen in younger individuals due to lifestyle factors such as poor diet and lack of exercise. Type 1 Diabetes, on the other hand, typically develops in childhood or adolescence and is not associated with age over 40. Choices C and D are left blank as they are not relevant to the question.

5. A client with Crohn's disease is receiving parenteral nutrition. Which of the following interventions should the nurse not include in the care of this client?

• A. Remove the parenteral nutrition solution from the refrigerator 2 hours before infusion.
• B. Remove unused parenteral nutrition after 12 hours of use.
• C. Monitor daily laboratory values and report abnormalities as needed.
• D. Monitor the flow rate of the parenteral nutrition carefully and adjust it if necessary.

Correct answer: B

Rationale: In caring for a client receiving parenteral nutrition, it is important to follow proper guidelines to ensure safety and effectiveness. Unused parenteral nutrition should be removed after 24 hours, not 12 hours, to prevent contamination and reduce the risk of infection. Option A is correct as it ensures the solution is at room temperature before infusion. Option C is essential for monitoring the client's response to parenteral nutrition. Option D is important to maintain the correct flow rate and adjust it as needed. Therefore, option B is the incorrect choice among the options provided.

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