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 gastroesophageal reflux disease is being taught by a nurse about managing the illness. Which of the following recommendations should the nurse include in the teaching?

• A. Limit fluid intake not related to meals.
• B. Chew on mint leaves to relieve indigestion.
• C. Avoid eating within 3 hours of bedtime.
• D. Season foods with black pepper.

Correct answer: C

Rationale: The correct recommendation for managing gastroesophageal reflux disease is to avoid eating within 3 hours of bedtime. This helps prevent acid reflux by allowing food to digest before lying down. Choices A, B, and D are incorrect. Limiting fluid intake not related to meals is not a standard recommendation for managing GERD. Chewing on mint leaves may worsen symptoms as mint can relax the lower esophageal sphincter, allowing stomach acid to flow back up. Seasoning foods with black pepper does not specifically help manage GERD.

3. What gastrointestinal side effects are associated with antisecretory drugs such as proton pump inhibitors?

• A. Nausea and vomiting
• B. Gastroparesis
• C. Dumping syndrome
• D. Flatulence

Correct answer: A

Rationale: Proton pump inhibitors (PPIs) are a type of antisecretory drug that can cause nausea and vomiting by altering stomach acid production. These are common side effects associated with PPIs. Gastroparesis (B) is a condition that affects the stomach muscles and prevents proper stomach emptying; it is not a side effect of PPIs. Dumping syndrome (C) is a group of symptoms that can occur after having part of your stomach removed and is not a side effect of PPIs. While some people might experience flatulence (D) when taking PPIs, it is not as commonly associated with these drugs as the effects of nausea and vomiting.

4. Which of the following is not a desirable blood lipid value?

• A. low total cholesterol
• B. high LDL
• C. high HDL
• D. low blood triglycerides

Correct answer: B

Rationale: The correct answer is B. High levels of LDL (low-density lipoprotein) cholesterol are undesirable as they are associated with an increased risk of cardiovascular disease. Therefore, low total cholesterol (choice A), high HDL (choice C), and low blood triglycerides (choice D) are considered desirable blood lipid values. Low total cholesterol is beneficial as high levels can increase the risk of heart disease. High HDL cholesterol is considered good as it helps remove LDL cholesterol from the arteries. Low blood triglycerides are also preferred as high levels are associated with an increased risk of heart disease.

5. A nurse is providing dietary teaching for a client who has a burn injury and adheres to a vegan diet. The nurse should recommend which of the following foods as the best source of protein to promote wound healing?

• A. One cup of brown rice
• B. One cup of orange juice
• C. One cup of pureed avocado
• D. One cup of lentils

Correct answer: D

Rationale: Lentils are an excellent source of plant-based protein, essential for wound healing in a vegan diet. Brown rice, orange juice, and pureed avocado are not protein-rich foods like lentils and would not provide sufficient protein for wound healing in this scenario.

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