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 primarily determines the Dietary Reference Intake (DRI) for protein?

• A. Intake of fatty acids
• B. Gender
• C. Height
• D. Body weight

Correct answer: D

Rationale: The Dietary Reference Intake (DRI) for protein is primarily determined by an individual's body weight. This is because the body's protein requirement is proportionate to its size, which is generally reflected in the body weight. Therefore, choice D is correct. Choices A, B, and C are incorrect: While factors such as fatty acid intake, gender, and height can influence an individual's overall nutritional needs, they do not directly determine the DRI for protein.

3. Which of the following questions illustrates the group role of encourager?

• A. What were you saying?
• B. Who wants to respond next?
• C. Where do you go from here?
• D. Why haven’t we heard from you?

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. Why is atherosclerosis dangerous to arterial function?

• A. It diminishes central circulation
• B. It causes decreased blood pressure on artery walls
• C. It narrows the arterial lumen so a clot can easily block it
• D. It increases arterial elasticity

Correct answer: C

Rationale: Atherosclerosis is dangerous to arterial function because it narrows the arterial lumen, increasing the risk of a clot completely blocking the blood flow. This can lead to severe cardiovascular events such as heart attacks or strokes. Choice A is incorrect since atherosclerosis does not primarily diminish central circulation, but rather, it impedes local blood flow where the plaque is present. Choice B is also incorrect as atherosclerosis increases the pressure on artery walls due to the narrowed space for blood flow, not decrease it. Lastly, choice D is incorrect as atherosclerosis causes the arteries to lose their elasticity, not increase it.

5. Why does Anita stand in front of the mirror while performing a Breast Self-Examination (BSE)?

• A. To check for unusual discharges from the breast
• B. To check for any obvious malignancy
• C. To observe the size and contour of the breast
• D. To check for thickness and lumps in the breast

Correct answer: C

Rationale: When performing a Breast Self-Examination (BSE), one of the reasons for standing in front of a mirror is to observe the size and contour of the breast (Choice C). This helps in identifying any visible changes or abnormalities such as dimpling, puckering, or changes in the size and shape of the breasts. While unusual discharges (Choice A) and thickness or lumps (Choice D) can be part of the changes a person might notice during a BSE, these are typically identified by palpation or by squeezing the nipple for discharge, not by just looking in the mirror. Choice B, checking for obvious malignancy, is too vague and not specific enough as malignancy is often not visible to the naked eye.

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