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. What is the most likely complication for a client receiving TPN who suddenly develops tremors, dizziness, and diaphoresis?

• A. Fluid volume overload
• B. Sepsis
• C. Hyperglycemia
• D. Hypoglycemia

Correct answer: D

Rationale: The correct answer is D, Hypoglycemia. When a client receiving TPN suddenly develops tremors, dizziness, and diaphoresis, it is indicative of hypoglycemia. TPN provides a high concentration of glucose, and if it is abruptly stopped or the infusion rate is reduced, it can lead to hypoglycemia. Choices A, B, and C are incorrect as they do not directly correlate with the symptoms described in the scenario. Fluid volume overload typically presents with edema and hypertension, sepsis with fever and increased heart rate, and hyperglycemia with polyuria, polydipsia, and blurred vision.

3. Which neuromuscular disease is characterized by abnormal chewing and swallowing patterns, tremors of the mandible, lip, and tongue, frequent drooling, and holding food in the mouth for extended periods?

• A. Developmental disabilities
• B. Parkinson's disease
• C. Epilepsy
• D. Diabetes mellitus

Correct answer: B

Rationale: The correct answer is B, Parkinson's disease. Parkinson's disease is characterized by abnormal chewing and swallowing patterns, tremors of the mandible, lip, and tongue, frequent drooling, and difficulties in oral functions like holding food in the mouth. Developmental disabilities (Choice A) do not specifically cause these symptoms related to neuromuscular function. Epilepsy (Choice C) is a neurological disorder characterized by recurrent seizures and does not typically present with the described symptoms. Diabetes mellitus (Choice D) is a metabolic disorder that affects blood sugar regulation and does not directly cause the neuromuscular symptoms mentioned in the question.

4. The following are appropriate nursing interventions during colostomy irrigation, EXCEPT:

• A. Increase the irrigating solution flow rate when abdominal cramps is felt
• B. Insert 2-4 inches of an adequately lubricated catheter to the stoma
• C. Position client in semi-Fowler
• D. Hang the solution 18 inches above the stoma

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

5. A person who consumes mostly pre-packaged meals is likely consuming too much ____.

• A. iron
• B. zinc
• C. sodium
• D. riboflavin

Correct answer: C

Rationale: Pre-packaged meals often contain high levels of sodium, which can contribute to hypertension and other health issues when consumed in excess.

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