Nursing Elites

1. A common comorbidity in patients with Chronic Kidney Disease (CKD) is:

• A. Liver disease
• B. Malnutrition
• C. Acute renal failure
• D. Difficulty breathing

Correct answer: B

Rationale: Malnutrition is a common comorbidity in patients with Chronic Kidney Disease (CKD). This is mainly due to factors such as dietary restrictions, poor appetite, and the body's increased nutritional needs as it struggles to deal with the disease. Liver disease (Choice A) is not typically associated directly with CKD, although both conditions may coexist in some patients. Acute renal failure (Choice C) is not a comorbidity but a severe and potentially lethal progression of CKD. Difficulty breathing (Choice D) is not a comorbidity but can be a symptom of severe kidney disease or other underlying conditions. However, malnutrition is more commonly observed in CKD patients compared to difficulty breathing.

2. A mother asks about healthy snacks for her three children under 4 years old. All are wise choices the dental hygienist can recommend, except one. Which is the exception?

• A. Low-fat milk or yogurt
• B. Whole-grain cereals
• C. Raw vegetable sticks
• D. Nuts and seeds

Correct answer: D

Rationale: Nuts and seeds pose a choking hazard for children under 4 years old, making them an unsafe snack choice for young children. While low-fat milk or yogurt, whole-grain cereals, and raw vegetable sticks are healthy snack options suitable for children under 4 years old, nuts and seeds should be avoided due to the risk of choking, especially in young children who may not have fully developed chewing abilities.

3. A nurse is caring for a client who has a body mass index (BMI) of 30. Four weeks after nutritional counseling, which of the following evaluation findings indicates the plan of care was followed?

• A. BMI of 25
• B. Weight gain of 1.8 kg
• C. BMI of 33
• D. Weight loss of 2.7 kg

Correct answer: D

Rationale: A weight loss of 2.7 kg in four weeks indicates effective adherence to a nutritional plan aimed at reducing body mass index (BMI), moving towards a healthier weight. Choices A, B, and C are incorrect because a decrease in weight, as shown in choice D, is the desired outcome when managing a client with a BMI of 30 to reach a healthier range.

4. The most energy-rich nutrient is:

• A. carb
• B. fat
• C. protein
• D. water

Correct answer: B

Rationale: Fat provides 9 kcal per gram, making it the most energy-rich nutrient compared to carbohydrates and proteins, which provide 4 kcal per gram.

5. A nurse is planning care for a client who has ascites secondary to liver disease. Which of the following interventions should the nurse include in the plan of care?

• A. Reduce complex carbohydrates to 30% of total calories.
• B. Restrict protein intake to less than 0.8 g/kg/day.
• C. Decrease daily caloric intake by 20%.
• D. Limit sodium to 2000 mg or less per day.

Correct answer: D

Rationale: The correct answer is to limit sodium to 2000 mg or less per day. Ascites, which is the abnormal accumulation of fluid in the abdominal cavity, is commonly associated with liver disease. Limiting sodium intake helps manage fluid retention by reducing the fluid accumulation in the abdomen. Choices A, B, and C are incorrect because reducing complex carbohydrates, restricting protein intake, or decreasing caloric intake are not the primary interventions for managing ascites in liver disease.

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