Nursing Elites

1. The mechanism behind most CKD in patients without diabetes is mediated by:

• A. enzyme systems
• B. immune systems
• C. catabolic systems
• D. hormonal systems

Correct answer: B

Rationale: In non-diabetic patients, CKD is often mediated by immune system responses. Chronic inflammation triggered by immune system dysfunction can contribute to progressive kidney damage. Therefore, the correct answer is 'immune systems.' Choices A, C, and D are incorrect because CKD in non-diabetic patients is primarily associated with immune system abnormalities rather than enzyme, catabolic, or hormonal systems.

2. Each of the following nutrients provides energy except one. Which one is the exception?

• A. Proteins
• B. Carbohydrates
• C. Fats
• D. Vitamins

Correct answer: D

Rationale: The correct answer is D, Vitamins. While proteins, carbohydrates, and fats provide energy, vitamins do not. Vitamins are essential micronutrients that help regulate various biochemical processes in the body, such as metabolism and immunity. Choice A, B, and C are incorrect because proteins, carbohydrates, and fats are macronutrients that the body uses as a source of energy.

3. Ms. ANA had a car accident where he lost her boyfriend. As a result, she became passive and submissive. The nurse knows that the type of crisis Ms. ANA is experiencing is:

• A. Developmental crisis
• B. Maturational crisis
• C. Situational crisis
• D. Social Crisis

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.

4. All of the following are instructions for proper foot care to be given to a client with peripheral vascular disease caused by diabetes. Which one is not?

• A. Trim nails using a nail clipper
• B. Apply cornstarch to the foot
• C. Always check the temperature of the water before bathing
• D. Use canvas shoes

Correct answer: A

Rationale: The correct answer is 'A', which says trim nails using a nail clipper. This is incorrect because patients with peripheral vascular disease, particularly those caused by diabetes, should not trim their nails themselves due to the risk of injury, infection, and poor wound healing. The other options, 'B', 'C', and 'D', are correct advice for diabetic foot care. Applying cornstarch can help keep the feet dry and prevent fungal infections. Checking the water temperature before bathing can prevent burns, as patients with peripheral vascular disease often have decreased sensation in their feet. Wearing canvas shoes can improve foot ventilation and reduce the risk of foot ulcers and infections.

5. 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.

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