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. Where is Vitamin K synthesized?

• A. by bacteria in the GI tract
• B. by the body by sunlight
• C. deficiency is called beriberi
• D. found in vegetable oils

Correct answer: A

Rationale: Vitamin K is synthesized by bacteria in the gastrointestinal tract. Choice B is incorrect as the synthesis of Vitamin D, not K, can be induced by sunlight exposure. Choice C is incorrect as beriberi is a condition caused by thiamine (Vitamin B1) deficiency, not Vitamin K. Choice D is incorrect as Vitamin E is commonly found in vegetable oils, not Vitamin K.

3. Can bacterial plaque metabolize sucrose, lactose, and fructose? Is fructose, also known as levulose and found naturally in honey, less cariogenic than sucrose and lactose?

• A. Yes, bacterial plaque can metabolize these sugars, but no, fructose is not less cariogenic.
• B. No, bacterial plaque cannot metabolize these sugars, and fructose is not less cariogenic.
• C. Yes, bacterial plaque can metabolize these sugars, but no, fructose is not less cariogenic.
• D. No, bacterial plaque cannot metabolize these sugars, but yes, fructose is less cariogenic.

Correct answer: A

Rationale: The first statement is correct as bacterial plaque can indeed metabolize sucrose, lactose, and fructose. However, the second statement is inaccurate. Fructose, despite being found naturally in honey and known also as levulose, is not less cariogenic than either sucrose or lactose. This means that its consumption does not result in fewer cavities or tooth decay. Therefore, the correct answer is that bacterial plaque can metabolize these sugars, but fructose is not less cariogenic. Choices B, C, and D are incorrect because they either wrongly assert that bacterial plaque cannot metabolize these sugars or wrongly claim that fructose is less cariogenic.

4. What outcome has been shown to be a benefit of breastfeeding that directly impacts the mother?

• A. conserving calcium stores
• B. contracting the uterus
• C. protecting against future hypertension
• D. speeding the resumption of ovulation

Correct answer: B

Rationale: The correct answer is B, contracting the uterus. Breastfeeding helps contract the uterus after childbirth, reducing postpartum bleeding and helping the uterus return to its pre-pregnancy size more quickly. Choices A, C, and D are incorrect because conserving calcium stores, protecting against future hypertension, and speeding the resumption of ovulation are not direct benefits of breastfeeding to the mother.

5. To prevent recurrent attacks on client with glomerulonephritis, the nurse instructs the client to:

• A. Take a shower instead of tub baths
• B. Avoid situations that involve physical activity
• C. Continue the same restriction on fluid intake
• D. Seek early treatment for respiratory infection

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

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