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 nurse is providing teaching to a client who has type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?

• A. Albumin in my urine is an indication of normal kidney function.
• B. I will keep my HbA1c at five percent.
• C. I will have ketones in my urine if my blood glucose is maintained at 190 milligrams per deciliter.
• D. I will keep my blood glucose levels between 200 and 212 milligrams per deciliter.

Correct answer: B

Rationale: The correct answer is B. Maintaining an HbA1c level of 5 percent indicates good long-term blood glucose control and understanding of diabetes management. Choice A is incorrect because the presence of albumin in the urine (albuminuria) is actually an indication of kidney damage in diabetes. Choice C is incorrect as ketones in the urine are a sign of inadequate insulin and can occur when blood glucose levels are high, not at a specific level like 190 mg/dL. Choice D is also incorrect as the client should aim to keep blood glucose levels within a tighter range for better control, typically between 80-130 mg/dL before meals and less than 180 mg/dL after meals.

3. The nurse understands that malnutrition is a prevalent issue among hospitalized individuals. What is it commonly associated with?

• A. Decreased health care expenses
• B. Elevated blood pressure
• C. Decreased mortality rates
• D. A compromised immune system

Correct answer: D

Rationale: Malnutrition is often associated with a weakened immune system. This is because when the body is not sufficiently nourished, it lacks the necessary nutrients to maintain a well-functioning immune system, making patients more vulnerable to infections and other health complications. This can potentially increase mortality rates and prolong hospital stays, contrary to choice C. Choices A and B are incorrect as malnutrition does not lead to decreased health care costs or high blood pressure. In fact, it may increase health care costs due to the potential for increased complications and extended hospital stays.

4. A nurse is caring for a client who is receiving parenteral nutrition. Which of the following findings indicates the therapy is effective?

• A. Client has soft, formed bowel movements.
• B. Client’s mucous membranes are pink.
• C. Client reports ability to complete ADLs.
• D. Client’s blood glucose level is within the expected reference range.

Correct answer: D

Rationale: The correct answer is D because having a blood glucose level within the expected reference range indicates that parenteral nutrition is effectively meeting the client's nutritional needs. Choices A, B, and C are incorrect because soft, formed bowel movements, pink mucous membranes, and the ability to complete activities of daily living do not directly reflect the effectiveness of parenteral nutrition therapy.

5. Which statement by a client indicates a need for further teaching about food safety?

• A. I will use the food before the expiration date listed on the package.
• B. I will wash my strawberries before I eat them.
• C. I will drink unpasteurized milk as it has many gut-healthy probiotics.
• D. I will wash my hands after I prepare raw chicken.

Correct answer: C

Rationale: The correct answer is C because drinking unpasteurized milk can contain harmful bacteria, which poses a risk to food safety. Choice A is correct as it emphasizes using food before the expiration date. Choice B is also correct as washing fruits before consumption is a good food safety practice. Choice D is correct as well since washing hands after handling raw chicken is crucial to prevent cross-contamination. Therefore, choice C is the only statement that indicates a need for further teaching on food safety.

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