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. Which symptoms are associated with cancer of the colon?

• A. constipation, ascites, and mucus in the stool
• B. diarrhea, heartburn, and eructation
• C. blood in the stools, anemia, and 'pencil-shaped' stools
• D. anorexia, hematemesis, and increased peristalsis

Correct answer: C

Rationale: The correct symptoms associated with cancer of the colon are blood in the stools, anemia, and 'pencil-shaped' stools. These symptoms are classic indicators of colorectal cancer. Choices A, B, and D do not typically present in colorectal cancer. Constipation, ascites, and mucus in the stool are more commonly associated with other gastrointestinal conditions. Diarrhea, heartburn, and eructation are not typical symptoms of colon cancer. Anorexia, hematemesis, and increased peristalsis are more indicative of other gastrointestinal issues and not specific to colon cancer.

3. What is the function of the gallbladder?

• A. to store bile
• B. to produce bile
• C. to digest bile
• D. to modify bile to a liquid form

Correct answer: A

Rationale: The correct answer is A: "to store bile." The gallbladder acts as a reservoir for bile produced by the liver. It releases bile into the small intestine to aid in the digestion of fats. Choice B is incorrect because the liver produces bile, not the gallbladder. Choice C is incorrect as the gallbladder does not digest bile but stores and releases it for digestion. Choice D is incorrect because bile is already in liquid form; the gallbladder does not modify it to a liquid state.

4. The most energy-rich nutrient is:

• A. carb
• B. fat
• C. protein
• D. water

Correct answer: B

Rationale: Fat provides 9 kcal per gram, making it the most energy-rich nutrient compared to carbohydrates and proteins, which provide 4 kcal per gram.

5. A client with Crohn's disease is being cared for by a nurse. Which of the following food choices aligns with the recommended diet for clients with Crohn's disease?

• A. Vanilla milkshake
• B. Buttered popcorn
• C. Tossed green salad
• D. Toast with jelly

Correct answer: C

Rationale: The correct answer is a 'Tossed green salad.' Clients with Crohn's disease often benefit from a low-residue diet, which includes easily digestible foods like leafy green vegetables found in a tossed green salad. This type of diet helps minimize gastrointestinal symptoms. Choices A, B, and D are not ideal for clients with Crohn's disease. Vanilla milkshake, buttered popcorn, and toast with jelly may exacerbate symptoms due to their high fat, fiber, or sugar content, which can be harder to digest.

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