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. Churns chyme and has an environment of pH2; holds 4-6 cups of food:

• A. stomach
• B. pancreas
• C. large intestine
• D. small intestine

Correct answer: A

Rationale: The stomach churns food into chyme and has a highly acidic environment (pH 2) to aid in the digestion of proteins and other nutrients.

3. Skin care around the stoma is critical. Which of the following is not indicated as a skin care barriers?

• A. Apply liberal amount of mineral oil to the area
• B. Use karaya paste and rings around the stoma
• C. Clean the area daily with soap and water before applying bag
• D. Apply talcum powder twice a day

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. Mrs. Pichay who is for thoracentesis is assigned by the nurse to any of the following positions, EXCEPT:

• A. straddling a chair with arms and head resting on the back of the chair
• B. lying on the unaffected side with the bed elevated 30-40 degrees
• C. lying prone with the head of the bed lowered 15-30 degrees
• D. sitting on the edge of the bed with her feet supported and arms and head on a padded overhead table

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

5. Which types of diabetes are characterized by the body's cells becoming resistant to insulin? (Select all that apply)

• A. Gestational diabetes
• B. Type II diabetes
• C. Type I diabetes
• D. Both A and B

Correct answer: D

Rationale: In both gestational diabetes and Type II diabetes, the body's cells become resistant to insulin, leading to elevated blood glucose levels. Insulin resistance in these types of diabetes prevents glucose from entering the cells, causing it to accumulate in the bloodstream. On the other hand, Type I diabetes is characterized by the body's inability to produce insulin because the immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas. Therefore, the correct answer is both A and B. Choice C, Type I diabetes, is not characterized by insulin resistance but rather by the body's inability to produce insulin. Therefore, it is incorrect. Choice D, Both A and B, includes the correct options of gestational diabetes and Type II diabetes, making it the correct answer.

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