Nursing Elites

1. Why is starting a low CHO diet a contraindication for a client with renal insufficiency?

• A. As long as the client eats a minimum of 30g of CHO/day, there should be no problem.
• B. The client's clinical condition is a contraindication to starting a low CHO diet.
• C. Calcium supplements should be utilized to prevent the development of osteoporosis while on a low CHO diet.
• D. As long as the client eats foods that are high biologic protein sources, a low CHO diet can be followed.

Correct answer: B

Rationale: A client with renal insufficiency should not start a low CHO diet because it could result in an increased renal solute load. Clients with renal or liver disease require protein control in their diet to prevent complications. Proteins used must be of high biologic value, and protein intake is usually weight-based. Protein levels may be adjusted based on the client's clinical condition. A minimum level of carbohydrates is needed in the diet to spare protein. Vitamin and mineral supplements might be needed for clients with liver failure. The dietician plays a crucial role in calculating specific nutrient requirements for these clients and monitoring outcomes in conjunction with the healthcare team. Choice A is incorrect because simply consuming a minimum amount of carbohydrates does not address the issue of increased renal solute load. Choice C is incorrect as calcium supplements are not the primary concern when considering a low CHO diet for a client with renal insufficiency. Choice D is incorrect as the focus should be on the contraindication of a low CHO diet for a client with renal insufficiency rather than just high biologic protein sources.

2. What type of cells create exocrine secretions?

• A. alpha cells
• B. beta cells
• C. acinar cells
• D. plasma cells

Correct answer: C

Rationale: Acinar cells are responsible for creating exocrine secretions, such as enzymes and digestive juices. Alpha cells are found in the pancreas and are responsible for producing glucagon, beta cells produce insulin, and plasma cells are a type of white blood cell involved in immune responses. Therefore, the correct answer is acinar cells, as they specifically produce exocrine secretions.

3. A nurse working in a pediatric clinic observes bruises on the body of a four-year-old boy. The parents report the boy fell while riding his bike. The bruises are located on his posterior chest wall and gluteal region. What should the nurse do?

• A. Suggest a script for counseling the family to the doctor on duty.
• B. Recommend a warm bath for the boy to decrease healing time.
• C. Notify the case manager in the clinic about possible child abuse concerns.
• D. Recommend ROM exercises to the patient's spine to decrease healing time.

Correct answer: C

Rationale: In this scenario, the nurse is observing bruises on a child's body that are located in areas not commonly associated with accidental injuries. Given the concerning nature of the bruising pattern and the inconsistent history provided by the parents, the nurse should suspect possible child abuse and take appropriate action by notifying the case manager in the clinic. The safety and well-being of the child should always be the top priority. Counseling for the family, warm baths, or recommending range of motion (ROM) exercises are not appropriate actions in this situation and may not address the underlying issue of potential child abuse.

4. A client with stress incontinence should be advised:

• A. to avoid relying solely on absorbent undergarments.
• B. that Kegel exercises might help.
• C. that effective surgical treatments are available.
• D. that behavioral therapy can be beneficial.

Correct answer: B

Rationale: Kegel exercises, which involve tightening and releasing the pelvic floor muscles, can be beneficial for stress incontinence by strengthening the muscles that control urination. Choice A is incorrect as it is important for the client to know that absorbent undergarments can be used as a temporary solution but do not address the underlying issue. Choice C is incorrect as while surgical treatments are available, they are usually considered when conservative treatments like exercises and behavioral therapy have not been successful. Choice D is incorrect as behavioral therapy can be beneficial in managing stress incontinence through lifestyle and dietary modifications, bladder training, and more, contrary to the statement that it is ineffective.

5. A client with urinary tract calculi needs to avoid which of the following foods?

• A. lettuce
• B. cheese
• C. apples
• D. broccoli

Correct answer: B

Rationale: A client with urinary tract calculi needs to avoid foods high in calcium to prevent the formation of more stones. Cheese is high in calcium, so it should be avoided. Lettuce, apples, and broccoli are not typically associated with high calcium content and are safe options for individuals with urinary tract calculi. Therefore, the correct answer is cheese. Choices A, C, and D are not high in calcium and are safe for consumption by individuals with urinary tract calculi.

Similar Questions