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. A client with celiac disease should avoid which of the following?

• A. Quinoa
• B. Barley
• C. Rice
• D. Oats

Correct answer: B

Rationale: The correct answer is B: Barley. Barley contains gluten, which is harmful to individuals with celiac disease. Gluten triggers an immune response in people with celiac disease, damaging the lining of the small intestine. Choices A, C, and D (Quinoa, Rice, and Oats) are gluten-free and safe for individuals with celiac disease to consume.

3. If a person could not make bile, what would happen?

• A. experience fatigue, as the body would not be able to make lipid carriers to deliver fat to body cells for energy
• B. have less cholesterol being made by the liver
• C. need to consume higher levels of fat
• D. be unable to absorb most lipids, and fat would be excreted in the feces

Correct answer: D

Rationale: The correct answer is D. Bile is essential for emulsifying fats in the small intestine, allowing them to be absorbed. Without bile, most fats would not be absorbed and would be excreted in the feces. Choices A, B, and C are incorrect because the primary role of bile is in the digestion and absorption of fats, rather than affecting lipid carriers, cholesterol production, or dietary fat consumption.

4. Among people who are ill, significant weight loss may be masked by?

• A. dehydration
• B. a large tumor
• C. drug therapy
• D. fluid retention

Correct answer: D

Rationale: Fluid retention can mask weight loss in ill individuals as the retained fluid adds to body weight, making it difficult to detect true fat or muscle loss. Dehydration (Choice A) would actually lead to weight loss rather than masking it. While a large tumor (Choice B) could contribute to weight loss, it would not mask the weight loss itself. Drug therapy (Choice C) may cause side effects, including weight changes, but it is unlikely to mask significant weight loss in the same way that fluid retention does.

5. You will do nasopharyngeal suctioning on Mr. Abad. Your guide for the length of insertion of the tubing for an adult would be:

• A. tip of the nose to the base of the neck
• B. the distance from the tip of the nose to the middle of the neck
• C. the distance from the tip of the nose to the tip of the ear lobe
• D. eight to ten inches

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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