Nursing Elites

1. 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.

2. Which bond is formed by a positively charged metal ion and negatively charged nonmetal ion?

• A. Ionic bond
• B. Covalent bond
• C. Functional group
• D. Metallic bond

Correct answer: A

Rationale: The correct answer is an ionic bond. An ionic bond is formed when a positively charged metal ion joins with a negatively charged nonmetal ion, resulting in a transfer of electrons. In contrast, a covalent bond involves sharing electrons between atoms rather than complete transfer. Functional groups are specific groups of atoms within molecules that determine the molecule's chemical properties. Metallic bonds occur between metal atoms where electrons are shared across a delocalized electron cloud.

3. A nurse is teaching a group of clients who are at risk for heart disease about decreasing saturated fats in their diet. Which of the following fats should the nurse recommend the clients use when cooking?

• A. Palm oil
• B. Peanut oil
• C. Canola oil
• D. Stick margarine

Correct answer: C

Rationale: Canola oil is lower in saturated fats compared to palm oil, peanut oil, and stick margarine, making it a healthier option for clients at risk for heart disease. Palm oil is high in saturated fats, peanut oil has a moderate amount of saturated fats, and stick margarine is also high in saturated fats and trans fats, which are not heart-healthy choices.

4. Which of the following statements is correct about MyPlate?

• A. Canned fruit can be considered part of the fruit group
• B. Soymilk is considered part of the dairy group
• C. Beans and peas are considered part of both the protein group and the vegetable group
• D. Cream cheese and butter are not part of the dairy group

Correct answer: C

Rationale: According to the MyPlate guide, beans and peas are classified as part of both the protein and vegetable groups due to their high protein content and the nutrients they share with vegetables. This makes Choice C correct. Choice A is incorrect as canned fruit can be part of the fruit group if it's canned in water or 100% fruit juice. Soymilk is considered part of the dairy group, making Choice B incorrect. While cream cheese and butter are dairy products, they are not part of the dairy group on MyPlate because they contain little to no calcium, making Choice D incorrect.

5. 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.

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