Nursing Elites

1. For a patient on a ketogenic diet, which macronutrient is primarily increased?

• A. Carbohydrates
• B. Protein
• C. Fats
• D. Fiber

Correct answer: C

Rationale: The correct answer is C: Fats. A ketogenic diet is characterized by high fat intake, moderate protein intake, and very low carbohydrate intake. This diet aims to shift the body's metabolism to use fat as the primary source of energy instead of carbohydrates. Increasing fat intake while reducing carbohydrates is essential for achieving and maintaining a state of ketosis. Therefore, choices A, B, and D are incorrect as they do not align with the macronutrient adjustments required for a ketogenic diet.

2. What are the potential consequences of damage to the stomach?

• A. Reduced digestion of carbohydrates
• B. Inability to produce or secrete bile
• C. Inability to produce or secrete gastric acid
• D. Increased ability to produce or secrete intrinsic factor

Correct answer: C

Rationale: Damage to the stomach can lead to a reduced ability to produce gastric acid (Choice C) and intrinsic factor, the latter of which is crucial for vitamin B12 absorption (Choice D). That's why these two choices are correct. The stomach doesn't play a direct role in the digestion of carbohydrates (Choice A) as this process primarily occurs in the small intestine with the help of pancreatic enzymes. Similarly, bile is produced by the liver and stored in the gallbladder, not the stomach, hence stomach damage wouldn't lead to an inability to produce or secrete bile (Choice B).

3. What is the glomerular filtration rate for patients with stage 5 chronic kidney disease (CKD)?

• A. Less than 15 mL/min/1.73 m�
• B. Less than 30 mL/min/1.73 m�
• C. Less than 90 mL/min/1.73 m�
• D. Less than 125 mL/min/1.73 m�

Correct answer: A

Rationale: In patients with stage 5 chronic kidney disease (CKD), also known as end-stage renal disease, the kidney function is significantly compromised. This severe condition is characterized by a glomerular filtration rate (GFR) of less than 15 mL/min/1.73 m�, as correctly stated in choice A. Choices B, C, and D suggest higher GFR values, which are not indicative of stage 5 CKD. Specifically, a GFR of less than 30 mL/min/1.73 m� indicates stage 4 CKD, less than 90 mL/min/1.73 m� signifies stage 3 CKD, and a typical healthy individual usually has a GFR of around 125 mL/min/1.73 m�, which is far above the GFR for stage 5 CKD.

4. When doing an initial assessment, the best way for you to identify the client’s priority problem is to:

• A. Interview the client for chief complaints and other symptoms
• B. Talk to the relatives to gather data about history of illness
• C. Do auscultation to check for chest congestion
• D. Do a physical examination while asking the client relevant questions

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.

5. What activities best describe the work of the placenta during pregnancy?

• A. surrounding and cushioning the fetus
• B. combining maternal and fetal blood stores to exchange nutrients
• C. producing hormones that maintain the pregnancy
• D. absorbing vitamins and minerals that can be transferred to the fetus

Correct answer: C

Rationale: The placenta plays a crucial role in producing hormones that are necessary for maintaining pregnancy, supporting fetal development, and preparing the mother's body for childbirth. Choices A, B, and D are incorrect because the placenta's primary function is not to surround and cushion the fetus, combine blood stores for nutrient exchange, or absorb vitamins and minerals. While the placenta does facilitate the exchange of nutrients and oxygen between the mother and fetus, its hormone production is the most critical function during pregnancy.

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