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 statement indicates understanding of a low-fiber diet?

• 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 low in fiber compared to the other options provided. Option A contains high-fiber vegetables (carrots and celery), option B includes a bran muffin which is fiber-rich, and option C involves oatmeal which is also a good source of fiber. Therefore, choosing canned peaches aligns with a low-fiber diet.

3. Approximately 75% of reputable producers of bottled water use groundwater as their water source. Plain tap water is the most natural source of fluids.

• A. Both statements are true.
• B. Both statements are false.
• C. The first statement is true; the second is false.
• D. The first statement is false; the second is true.

Correct answer: A

Rationale: Both statements are true. Approximately 75% of reputable producers of bottled water use groundwater as their water source, which is the same source as the public water supply. Plain tap water, coming from underground sources or reservoirs, is indeed a natural source of fluids. The first statement is supported by the fact that groundwater is a common source for bottled water due to its purity and taste. The second statement is true as tap water is sourced from natural reservoirs or underground aquifers in most cases, making it a natural fluid source for consumption. Other choices are incorrect because both statements are factually accurate based on common practices in the production and sourcing of bottled water and tap water.

4. What activities best describe the work of the placenta during pregnancy?

• A. surrounding and cushioning the fetus
• B. combining maternal and fetal blood stores to exchange nutrients
• C. producing hormones that maintain the pregnancy
• D. absorbing vitamins and minerals that can be transferred to the fetus

Correct answer: C

Rationale: The placenta plays a crucial role in producing hormones that are necessary for maintaining pregnancy, supporting fetal development, and preparing the mother's body for childbirth. Choices A, B, and D are incorrect because the placenta's primary function is not to surround and cushion the fetus, combine blood stores for nutrient exchange, or absorb vitamins and minerals. While the placenta does facilitate the exchange of nutrients and oxygen between the mother and fetus, its hormone production is the most critical function during pregnancy.

5. The IVP reveals that Fe has small renal calculus that can be passed out spontaneously. To increase the chance of passing the stones, you instructed her to force fluids and do which of the following?

• A. Balanced diet C. Strain all urine
• B. Ambulate more D. Bed rest
• C.
• D.

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

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