Nursing Elites

1. A client is being instructed by a nurse about foods that should be included in a low-fiber diet. Which statement by the client indicates understanding?

• A. I can cut up carrots and celery sticks for my lunch.
• B. I will eat a bran muffin for my mid-morning snack.
• C. I will have oatmeal with skim milk for my breakfast.
• D. I should choose canned peaches for my fruit serving.

Correct answer: D

Rationale: The correct answer is D because canned peaches are lower in fiber compared to the other options. Carrots, celery sticks, bran muffins, and oatmeal are high-fiber choices, which are not suitable for a low-fiber diet. Choosing canned peaches aligns with the requirements of a low-fiber diet.

2. A client with frequent kidney stones is receiving dietary teaching from a nurse. Which of the following instructions should the nurse include?

• A. Limit your intake of dairy products.
• B. Increase your consumption of protein-rich foods.
• C. Avoid eating tree nuts, such as almonds.
• D. Take a vitamin C supplement twice daily.

Correct answer: A

Rationale: The correct answer is to instruct the client to limit their intake of dairy products. Dairy products are high in calcium and can contribute to kidney stone formation in susceptible individuals. Increasing protein intake may lead to higher excretion of calcium, which can exacerbate kidney stone formation. While tree nuts are high in oxalates, which can contribute to kidney stone formation, it is not the primary concern in this case. Vitamin C supplements can increase oxalate levels in the urine, potentially increasing the risk of kidney stone formation, so it should not be recommended.

3. Which of the following is a common sign of vitamin D deficiency?

• A. Brittle nails
• B. Muscle weakness
• C. Night blindness
• D. Hair loss

Correct answer: B

Rationale: Muscle weakness is a common sign of vitamin D deficiency. Vitamin D is essential for calcium absorption and bone health, and its deficiency can lead to muscle weakness. Brittle nails (Choice A) are not typically associated with vitamin D deficiency. Night blindness (Choice C) is related to vitamin A deficiency, not vitamin D deficiency. Hair loss (Choice D) can be linked to various factors, but it is not a common sign of vitamin D deficiency.

4. You are teaching your clients the difference between Type I (IDDM) and Type II (NDDM) diabetes. Which of the following statements is true?

• A. Both types of diabetes mellitus clients are prone to developing ketosis.
• B. Type II (NIDDM) is more common and preventable compared to Type I (IDDM) diabetes, which is genetic.
• C. Type I (IIDM) is characterized by fasting hyperglycemia.
• D. Type II (NIDDM) is characterized by abnormal immune response.

Correct answer: D

Rationale: The correct answer is D. Type II diabetes (NIDDM) is characterized by insulin resistance and a relative lack of insulin. It is not primarily characterized by an abnormal immune response. Option A is incorrect because only Type I diabetes clients are prone to developing ketosis due to a lack of insulin. Option B is incorrect because while Type II diabetes is more common and often preventable through lifestyle changes, it is not solely genetic. Option C is incorrect because Type I diabetes, not Type II, is characterized by fasting hyperglycemia due to an absolute lack of insulin production.

5. All of the following are instructions for proper foot care to be given to a client with peripheral vascular disease caused by diabetes. Which one is not?

• A. Trim nails using a nail clipper
• B. Apply cornstarch to the foot
• C. Always check the temperature of the water before bathing
• D. Use canvas shoes

Correct answer: A

Rationale: The correct answer is 'A', which says trim nails using a nail clipper. This is incorrect because patients with peripheral vascular disease, particularly those caused by diabetes, should not trim their nails themselves due to the risk of injury, infection, and poor wound healing. The other options, 'B', 'C', and 'D', are correct advice for diabetic foot care. Applying cornstarch can help keep the feet dry and prevent fungal infections. Checking the water temperature before bathing can prevent burns, as patients with peripheral vascular disease often have decreased sensation in their feet. Wearing canvas shoes can improve foot ventilation and reduce the risk of foot ulcers and infections.

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