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. A nurse is teaching a client about strategies to prevent constipation. Which of the following statements by the client indicates an understanding of the teaching?

• A. Drinking four to five glasses of water per day will prevent constipation.
• B. I should consume mineral oil once per day.
• C. Eating foods high in fiber will make elimination easier.
• D. I can skip a meal if I feel bloated.

Correct answer: C

Rationale: The correct answer is C. Eating foods high in fiber increases stool bulk and promotes easier elimination, thus preventing constipation. Choices A, B, and D are incorrect. Drinking water is important, but the emphasis should be on high-fiber foods. Mineral oil is not a recommended first-line treatment for constipation, and skipping meals can disrupt regular bowel movements, potentially leading to constipation.

3. Which nutrient has the highest satiety value?

• A. Complex carbohydrates
• B. High-quality protein
• C. Low-quality protein
• D. Fat

Correct answer: D

Rationale: Fat has the highest satiety value among the listed nutrients. It slows down digestion, stays in the stomach longer, and provides a sustained release of energy, leading to increased feelings of fullness and satisfaction. Complex carbohydrates can also contribute to satiety, but fat generally has a stronger effect. High-quality protein is important for satiety as well, but it is generally not as filling as fat. Low-quality protein does not have as significant satiating effects as high-quality protein or fat.

4. The nurse notes that the fall might also cause a possible head injury. The patient will be observed for signs of increased intracranial pressure which include:

• A. Narrowing of the pulse pressure
• B. Vomiting
• C. Periorbital edema
• D. A positive Kernig's sign

Correct answer: C

Rationale: Periorbital edema is a sign of increased intracranial pressure. It is caused by fluid accumulation around the eyes due to compromised drainage. Narrowing of the pulse pressure is more indicative of shock than increased intracranial pressure. While vomiting can be a sign of increased intracranial pressure, it is not as specific as periorbital edema. A positive Kernig's sign is associated with meningitis, not increased intracranial pressure.

5. What would a diet manual most likely contain?

• A. Procedures for disinfecting cooking surfaces
• B. Staff sanitation guidelines
• C. Information on specific patients' resting metabolic rates
• D. Specific food preparation methods

Correct answer: D

Rationale: A diet manual typically contains guidance on specific food preparation methods to ensure proper nutrition and health for individuals following the diet. Therefore, choice D is correct. Choices A and B refer to sanitation procedures and staff hygiene issues, which are important but not typically the focus of a diet manual. Choice C, regarding specific patients' resting metabolic rates, is too individualized and detailed for a general diet manual, as it would be part of a personalized dietary plan developed with a healthcare professional.

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