Nursing Elites

1. Which dietary modification is most suitable for a client with type 2 diabetes who wants to improve glycemic control?

• A. Increase intake of saturated fats
• B. Decrease intake of refined carbohydrates
• C. Completely avoid all fruits
• D. Increase intake of sugary snacks

Correct answer: B

Rationale: Decreasing the intake of refined carbohydrates is the most effective dietary modification for a client with type 2 diabetes who aims to improve their glycemic control. Refined carbohydrates can cause sudden spikes in blood sugar levels, making diabetes management more difficult. Increasing the intake of saturated fats (Choice A) is not advisable as it can negatively impact heart health. Completely avoiding all fruits (Choice C) is unnecessary because most fruits have a low glycemic index and provide essential nutrients. Increasing the intake of sugary snacks (Choice D) will deteriorate glycemic control due to their high sugar content.

2. A nurse is providing discharge teaching about food choices to a client who has hypokalemia. Which of the following foods should the nurse identify as the best source of potassium?

• A. 1 cup grapes
• B. 1 cup shredded lettuce
• C. 1 cup cooked tomatoes
• D. 1 cup apple slices

Correct answer: C

Rationale: Cooked tomatoes are high in potassium, which is crucial for maintaining normal cell function, nerve transmission, and muscle contraction, making them a suitable choice for addressing hypokalemia. Grapes, shredded lettuce, and apple slices do not contain as much potassium as cooked tomatoes, so they are not the best choice for addressing hypokalemia.

3. A client receiving total parenteral nutrition (TPN) suddenly develops tremors, dizziness, and diaphoresis. The client said, 'I feel weak and the bag was empty.' Which is the most likely complication the client is currently experiencing?

• A. Fluid volume overload
• B. Sepsis
• C. Hyperglycemia
• D. Hypoglycemia

Correct answer: D

Rationale: The client experiencing tremors, dizziness, diaphoresis, weakness, and stating that the TPN bag is empty is likely experiencing hypoglycemia. Hypoglycemia can occur when the TPN infusion suddenly stops, leading to a rapid drop in blood sugar levels. Symptoms of hypoglycemia include tremors, dizziness, diaphoresis, and weakness. Choices A, B, and C are incorrect as the symptoms presented are more consistent with hypoglycemia rather than fluid volume overload, sepsis, or hyperglycemia.

4. Which gluten-free food choice would be most appropriate for a patient with celiac disease?

• A. Scalloped potatoes
• B. Oatmeal
• C. Eggs
• D. Tortillas

Correct answer: C

Rationale: Eggs are a safe food choice for individuals with celiac disease as they are naturally gluten-free. Scalloped potatoes often contain flour in the sauce, which might contain gluten. Oatmeal can be a subject of debate due to possible cross-contamination during processing, so it might not be safe unless labeled gluten-free. Tortillas are typically made from wheat flour containing gluten, but gluten-free versions are available. However, eggs are universally gluten-free, making them the best choice for individuals with celiac disease.

5. A nurse is providing teaching to an obese client who has gestational diabetes and is at 25 weeks of gestation. Which of the following statements made by the client indicates a need for further teaching?

• A. This does not mean that my baby will have this disease.
• B. This means that I will have diabetes for the rest of my life.
• C. If I feel dizzy, I should drink six ounces of a non-diet soda.
• D. Being obese might be one reason why I developed diabetes.

Correct answer: B

Rationale: The statement 'This means that I will have diabetes for the rest of my life' indicates a need for further teaching. Gestational diabetes often resolves after pregnancy, although it does indicate a higher risk for developing type 2 diabetes in the future. The other choices are correct or provide appropriate information: A) Understanding that gestational diabetes does not mean the baby will have the disease is accurate. C) Advising to drink non-diet soda if feeling dizzy is incorrect and potentially harmful due to the sugar content. D) Recognizing that obesity can be a risk factor for developing diabetes is a valid statement.

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