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. Each statement is true of proteins, except one. Which is the exception?

• A. Proteins are composed of building blocks called amino acids
• B. The classification of the 20 common amino acids is based on the properties of their side chains
• C. The general structure of an amino acid varies considerably
• D. Amino acids polymerize to form long chains called polypeptides

Correct answer: B

Rationale: The correct answer is B. The classification of the 20 common amino acids is not based on the properties of their side chains, but rather on the structure of their amino and carboxyl groups. These groups are consistent among all amino acids, while the side chains, also known as R groups, are what vary and give each amino acid its unique properties. Choice A is correct because proteins are indeed composed of amino acids. Choice C is incorrect because while the side chains of amino acids can vary, the general structure of an amino acid - a central carbon atom bonded to an amino group, a carboxyl group, a hydrogen atom, and a side chain - is consistent. Choice D is correct because amino acids do polymerize to form long chains called polypeptides, which can then fold into complex shapes to form proteins.

3. Which of the following is the most important risk factor for development of Chronic Obstructive Pulmonary Disease?

• A. Cigarette smoking
• B. Occupational exposure
• C. Air pollution
• D. Genetic abnormalities

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

4. A client is following Seventh-Day Adventist dietary laws. Which of the following dietary guidelines should the nurse include in the plan of care?

• A. Replace salt with pepper when seasoning food.
• B. Request that coffee is removed from meal trays.
• C. Offer pork with two meals per week.
• D. Provide a high-protein snack between meals.

Correct answer: B

Rationale: Seventh-Day Adventists typically avoid stimulants like caffeine, so requesting that coffee be removed from meal trays is appropriate. Choice A is incorrect because it does not specifically relate to Seventh-Day Adventist dietary guidelines. Choice C is incorrect as pork is generally avoided in Seventh-Day Adventist dietary laws. Choice D is incorrect as it does not address the specific dietary preferences of Seventh-Day Adventist clients.

5. The nurse is planning education about appropriate protein food choices for a client who has recently been prescribed a renal diet. Which protein food items should the nurse include in the education?

• A. Yogurt, seeds, and lentils
• B. Beef, bacon, and nuts
• C. Peanut butter, beans, and peas
• D. Poultry, eggs, and fish

Correct answer: D

Rationale: The correct answer is D: Poultry, eggs, and fish. These protein sources are high-quality proteins suitable for a renal diet as they provide essential amino acids without excessive amounts of potassium or phosphorus. Choice A, yogurt, seeds, and lentils, may be high in potassium and phosphorus, which could be restricted in a renal diet. Choice B, beef, bacon, and nuts, are also high in phosphorus and may not be ideal for a renal diet. Choice C, peanut butter, beans, and peas, are high in potassium and phosphorus, making them less suitable for a renal diet.

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