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. During operation, who manages the lighting, noise, temperature and other factors in the operating room suite?

• A. Nurse Supervisor
• B. Surgeon
• C. Circulating Nurse
• D. Scrub Nurse

Correct answer: C

Rationale: In an operating room, the circulating nurse is responsible for managing environmental factors such as lighting, noise, and temperature. This role includes ensuring the comfort and safety of the patient, as well as the efficiency of the team. While the Nurse Supervisor, Surgeon, and Scrub Nurse also have crucial roles during an operation, they do not directly manage the environmental conditions of the operating room. The rationale provided does not directly address the question asked, and appears to relate more to the broader role of nursing in patient care.

3. Which adolescent student lunch, evaluated by the school nurse, is the least nutritious?

• A. Ham sandwich, apple, and milk
• B. Hamburger, fries, and soft drink
• C. Macaroni and cheese, green beans, and peaches
• D. Meatloaf, broccoli, and pear slices

Correct answer: B

Rationale: The correct answer is B: Hamburger, fries, and soft drink. This meal is considered the least nutritious among the options provided due to its high content of unhealthy fats, processed carbohydrates, and added sugars, which lack essential nutrients. On the other hand, choice A: Ham sandwich, apple, and milk, offers a balanced meal with protein, fiber, vitamins, and calcium. Choice C: Macaroni and cheese, green beans, and peaches, provides a mixture of carbohydrates, vegetables, and fruits. Choice D: Meatloaf, broccoli, and pear slices, includes protein, fiber, and vitamins. Thus, all choices except B provide a more balanced and nutritious meal.

4. A patient has begun taking furosemide to manage heart failure. What food should the nurse recommend that the patient consume frequently while taking this drug?

• A. legumes
• B. cabbage
• C. peanut butter
• D. bananas

Correct answer: D

Rationale: Furosemide is a diuretic that can lead to potassium loss; therefore, it is recommended that patients consume potassium-rich foods like bananas to prevent hypokalemia.

5. What is the approximate energy value of alcohol?

• A. 3 kcal/g
• B. 7 kcal/g
• C. 10 kcal/g
• D. 25 kcal/g

Correct answer: B

Rationale: The correct answer is B: 7 kcal/g. Alcohol provides approximately 7 kilocalories per gram, making it a significant source of energy or 'empty calories' in the diet that do not contain any nutrients. 'Empty calories' refer to the calorie content without the presence of essential nutrients. Choices A, C, and D are incorrect. The energy values of 3 kcal/g, 10 kcal/g, and 25 kcal/g are not accurate for alcohol; instead, they may pertain to other nutrients such as carbohydrates (approximately 4 kcal/g), fats (approximately 9 kcal/g), and oils (approximately 9 kcal/g).

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