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 paranoid client refuses to eat telling you that you poisoned his food. The best intervention to this client is:

• A. Taste the food in front of him and tell him that the food is not poisoned
• B. Offer other types of food until the client eats
• C. Simply state that the food is not poisoned
• D. Offer sealed foods

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.

3. A condition that often progresses to become type 2 diabetes mellitus is:

• A. type 1 diabetes mellitus
• B. high blood pressure
• C. chronic pancreatitis
• D. impaired glucose tolerance

Correct answer: D

Rationale: Impaired glucose tolerance is a pre-diabetic state characterized by higher than normal blood sugar levels. It is often associated with insulin resistance and can progress to type 2 diabetes mellitus. Type 1 diabetes mellitus (Choice A) is an autoimmune condition where the body attacks insulin-producing cells, leading to a lack of insulin production. High blood pressure (Choice B) and chronic pancreatitis (Choice C) are not directly linked to the progression to type 2 diabetes mellitus.

4. Which of the following is a normal finding during assessment of a Chest tube in a 3 way bottle system?

• A. There is a continuous bubbling in the drainage bottle
• B. There is an intermittent bubbling in the suction control bottle
• C. The water fluctuates during inhalation of the patient
• D. There is 3 cm of water left in the water seal bottle

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.

5. 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.

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