Nursing Elites

1. The recommended daily fluid intake of patients maintained using hemodialysis is:

• A. 150 mL plus the volume of urinary output
• B. 500 mL plus the volume of urinary output
• C. 1000 mL plus the volume of urinary output
• D. 1500 mL plus the volume of urinary output

Correct answer: C

Rationale: The correct answer is C: 1000 mL plus the volume of urinary output. Fluid intake is typically restricted in hemodialysis patients to prevent fluid overload. The recommended daily fluid intake for these patients is 1000 mL plus any urinary output. Choice A (150 mL plus the volume of urinary output) is too low and would not provide enough fluid for these patients. Choice B (500 mL plus the volume of urinary output) is also insufficient. Choice D (1500 mL plus the volume of urinary output) is too high and may lead to fluid overload in hemodialysis patients.

2. A client with nephropathy secondary to diabetes mellitus is receiving dietary teaching from a nurse and plans to make dietary adjustments. Which of the following instructions should the nurse include?

• A. Consume less than 45% of total calories from carbohydrates per day.
• B. Eat no more than 300 mg of cholesterol per day.
• C. Consume less than 0.8 g/kg of body weight of protein per day.
• D. Eat at least 45 g of fiber per day.

Correct answer: D

Rationale: For a client with nephropathy secondary to diabetes mellitus, increasing fiber intake is essential as it can help manage blood sugar levels and improve overall bowel health. Choice A is incorrect because carbohydrates should be controlled but not limited to less than 45% of total calories. Choice B is incorrect as the recommended daily cholesterol intake for individuals with diabetes is less than 200 mg. Choice C is incorrect as protein intake should be individualized based on the client's condition and should not be limited to less than 0.8 g/kg of body weight per day.

3. A client who is in her second trimester of pregnancy should increase her caloric intake by how many calories during this trimester?

• A. 110 cal/day
• B. 225 cal/day
• C. 340 cal/day
• D. 450 cal/day

Correct answer: C

Rationale: During the second trimester of pregnancy, it is recommended that a client increases their caloric intake by around 340 calories per day to support the growing needs of both the mother and the developing fetus. This additional intake helps ensure the proper nutrition and energy levels required during this crucial stage of pregnancy. Option A (110 cal/day) is too low to meet the increased demands. Option B (225 cal/day) is also below the recommended amount. Option D (450 cal/day) is higher than necessary and could lead to excessive weight gain, which is not ideal during pregnancy.

4. Proteolytic enzymes are most likely to break down which food type?

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

Correct answer: B

Rationale: Proteolytic enzymes target proteins for breakdown into amino acids. Carbohydrates are broken down by enzymes like amylase, while fats are broken down by lipase. Lipids, which include fats, are not specifically targeted by proteolytic enzymes.

5. The client is discussing sources of carbohydrates with a nurse recently diagnosed with diabetes. Which food(s) identified by the client indicate understanding? (SATA)

• A. Starch
• B. Fiber
• C. Sugar
• D. All of the above

Correct answer: D

Rationale: The correct answer is D because starch, fiber, and sugar are all sources of carbohydrates. Starchy foods like bread, rice, and potatoes contain starch; fruits, vegetables, and whole grains provide fiber; and sugars are found in sweet foods like fruits, honey, and desserts. Fatty acids and amino acids are not sources of carbohydrates, so choices A, B, and C are correct while choices A and B are incorrect.

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