Nursing Elites

1. A nurse is educating a group of older adults in a community center on weight management using the BMI scale. Using the client's height and weight to calculate BMI, which of the following clients has a healthy BMI?

• A. A client with a weight of 128 lb and height of 70 inches
• B. A client with a weight of 150 lb and height of 68 inches
• C. A client with a weight of 200 lb and height of 72 inches
• D. A client with a weight of 133 lb and height of 60 inches

Correct answer: A

Rationale: To determine a healthy BMI, we need to calculate it using the formula: BMI = weight (lbs) / height^2 (inches) x 703. For choice A, BMI = 128 / (70 x 70) x 703 = 18.38, which falls within the healthy BMI range of 18.5-24.9. Therefore, choice A is correct. Choices B, C, and D have BMIs of 22.8, 27.1, and 26.1, respectively, which are outside the healthy range. Thus, choices B, C, and D are incorrect.

2. How many calories are contained in a food that has 15 grams of carbohydrates, 4 grams of protein, and 10 grams of fat?

• A. 106
• B. 124
• C. 166
• D. 202

Correct answer: C

Rationale: To calculate the total calories in a food item, you can use the following conversions: every 1 gram of carbohydrate provides 4 calories, 1 gram of protein provides 4 calories, and 1 gram of fat provides 9 calories. Therefore, for this food item, multiply 15 grams of carbohydrates by 4 calories/gram, 4 grams of protein by 4 calories/gram, and 10 grams of fat by 9 calories/gram. The calculation would be (15 * 4) + (4 * 4) + (10 * 9) = 60 + 16 + 90 = 166 calories. Choice A (106) is incorrect because it does not consider the calories from fat. Choice B (124) is incorrect as it underestimates the calories by not including all macronutrients. Choice D (202) is incorrect as it overestimates the calories by adding up the values incorrectly.

3. What is the glomerular filtration rate for patients with stage 5 chronic kidney disease (CKD)?

• A. Less than 15 mL/min/1.73 m�
• B. Less than 30 mL/min/1.73 m�
• C. Less than 90 mL/min/1.73 m�
• D. Less than 125 mL/min/1.73 m�

Correct answer: A

Rationale: In patients with stage 5 chronic kidney disease (CKD), also known as end-stage renal disease, the kidney function is significantly compromised. This severe condition is characterized by a glomerular filtration rate (GFR) of less than 15 mL/min/1.73 m�, as correctly stated in choice A. Choices B, C, and D suggest higher GFR values, which are not indicative of stage 5 CKD. Specifically, a GFR of less than 30 mL/min/1.73 m� indicates stage 4 CKD, less than 90 mL/min/1.73 m� signifies stage 3 CKD, and a typical healthy individual usually has a GFR of around 125 mL/min/1.73 m�, which is far above the GFR for stage 5 CKD.

4. Which of the following groups of vitamins are fat-soluble?

• A. vitamins B and C
• B. vitamins A and C
• C. vitamins B, E, K, D
• D. vitamins A, E, K, D

Correct answer: D

Rationale: The correct answer is D: vitamins A, E, K, and D. Fat-soluble vitamins are absorbed along with fats in the diet and can be stored in the body's fatty tissue. Vitamins B and C are water-soluble vitamins and are not stored in the body; any excess amounts are usually excreted in the urine. Therefore, choices A, B, and C are incorrect.

5. Clients may benefit from slightly higher fat intakes than are normally recommended if they have:

• A. congestive heart failure
• B. cerebrovascular accident
• C. peripheral vascular disease
• D. chronic obstructive pulmonary disease

Correct answer: D

Rationale: In chronic obstructive pulmonary disease (COPD), higher fat intake can be beneficial because it provides more calories with less respiratory burden compared to carbohydrates. Choices A, B, and C are incorrect because congestive heart failure, cerebrovascular accident, and peripheral vascular disease do not specifically benefit from higher fat intakes as in COPD.

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