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 condition has been shown to be associated with esophageal dysphagia?

• A. myasthenia gravis
• B. achalasia
• C. Alzheimer's disease
• D. cerebral palsy

Correct answer: B

Rationale: Achalasia is the correct answer. It is a condition characterized by the esophagus having difficulty moving food toward the stomach, resulting in dysphagia (difficulty swallowing). Myasthenia gravis (Choice A) is a neuromuscular disorder that affects skeletal muscles, not the esophagus. Alzheimer's disease (Choice C) primarily affects cognitive function, not the esophagus. Cerebral palsy (Choice D) is a neurological disorder affecting body movement and muscle coordination, unrelated to esophageal dysphagia.

3. Weight loss therapies that rely on juicing typically provide increased fiber, vitamins, and minerals. As an added incentive, juices contain a lower concentration of sugar than the whole fruit. Are these statements true or false?

• A. Both statements are true
• B. Both statements are false
• C. The first statement is true; the second is false
• D. The first statement is false; the second is true

Correct answer: B

Rationale: The correct answer is both statements are false. The process of juicing often extracts the liquid components of fruits and vegetables, leaving behind the fiber-rich pulp. Therefore, juicing does not typically provide increased fiber. Additionally, juices can contain a higher concentration of sugar than whole fruits because the fiber, which helps to slow down the absorption of sugar, has been removed. This can lead to a spike in blood sugar levels after consumption. The other options are incorrect because they contain at least one false statement.

4. A nurse is discussing sources of vitamin K with a client. Which food should the nurse recommend?

• A. Fish
• B. Leafy greens
• C. Citrus fruits
• D. Nuts

Correct answer: B

Rationale: Leafy greens are rich in vitamin K, which is important for blood clotting.

5. A client scheduled for hysterosalpingography needs health teaching before the procedure. The nurse is correct in telling the patient that:

• A. She needs to void prior to the procedure
• B. A full bladder is needed prior to the procedure
• C. Painful sensation is felt as the needle is inserted
• D. Flushing sensation is felt as the dye in injected

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.

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