Nursing Elites

1. A client with nephropathy secondary to diabetes mellitus is receiving dietary teaching from a nurse and plans to make dietary adjustments. Which of the following instructions should the nurse include?

• A. Consume less than 45% of total calories from carbohydrates per day.
• B. Eat no more than 300 mg of cholesterol per day.
• C. Consume less than 0.8 g/kg of body weight of protein per day.
• D. Eat at least 45 g of fiber per day.

Correct answer: D

Rationale: For a client with nephropathy secondary to diabetes mellitus, increasing fiber intake is essential as it can help manage blood sugar levels and improve overall bowel health. Choice A is incorrect because carbohydrates should be controlled but not limited to less than 45% of total calories. Choice B is incorrect as the recommended daily cholesterol intake for individuals with diabetes is less than 200 mg. Choice C is incorrect as protein intake should be individualized based on the client's condition and should not be limited to less than 0.8 g/kg of body weight per day.

2. Which test is used to monitor the degree of blood glucose control over a long period?

• A. Glucose tolerance test
• B. Glycated hemoglobin level
• C. Self-monitoring of blood glucose
• D. 24-hour urinary glucose excretion

Correct answer: B

Rationale: The correct answer is B, glycated hemoglobin level. The glycated hemoglobin (HbA1c) test measures the average blood glucose levels over the past 2-3 months, providing a long-term picture of glucose control. Choice A, the glucose tolerance test, measures how well your body processes glucose but is not specifically for long-term monitoring. Choice C, self-monitoring of blood glucose, involves daily testing by individuals, providing immediate rather than long-term information. Choice D, 24-hour urinary glucose excretion, measures the amount of glucose excreted in the urine over 24 hours and is not typically used for long-term monitoring of blood glucose control.

3. Which foods should be avoided on a low-potassium diet? (SATA)

• A. Bananas
• B. A, C
• C. Sweet potatoes
• D. Frozen corn

Correct answer: B

Rationale: Bananas, sweet potatoes, and orange juice are high in potassium.

4. A nurse is caring for an antepartum client who has iron-deficiency anemia. When teaching the client about nutrition, the nurse should emphasize the need for an increased intake of which of the following foods?

• A. Milk and cheese
• B. Red meat and organ meat
• C. Fresh fruits
• D. Whole grain breads

Correct answer: B

Rationale: The correct answer is red meat and organ meat. These foods are rich sources of heme iron, which is more easily absorbed by the body compared to non-heme iron found in plant-based foods. Red meat and organ meat can significantly help in increasing the iron levels in individuals with iron-deficiency anemia, especially in antepartum clients. Fresh fruits, while nutritious, do not provide high amounts of iron. Milk and cheese are not the best sources of iron for individuals with iron-deficiency anemia. Whole grain breads also do not contain as much bioavailable iron as red meat and organ meat.

5. Which change during pregnancy is related to the slowing of the gastrointestinal tract?

• A. Diarrhea
• B. Constipation
• C. Decreased absorption of iron
• D. Decreased absorption of calcium

Correct answer: B

Rationale: During pregnancy, the gastrointestinal tract tends to slow down, leading to constipation. This is due to hormonal changes that relax the intestinal muscles, allowing more time for nutrient absorption and ultimately leading to constipation. Diarrhea is not typically associated with the slowing of the gastrointestinal tract during pregnancy. Decreased absorption of iron and calcium may occur during pregnancy due to increased demands, but they are not directly related to the slowing of the gastrointestinal tract.

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