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. Dina, 17 years old, asks you how a tubal ligation prevents pregnancy. Which would be the best answer?

• A. Prostaglandins released from the cut fallopian tubes can kill sperm
• B. Sperm cannot enter the uterus because the cervical entrance is blocked
• C. Sperm can no longer reach the ova, because the fallopian tubes are blocked
• D. The ovary no longer releases ova as there is nowhere for them to go

Correct answer: C

Rationale: The correct answer is C: 'Sperm can no longer reach the ova because the fallopian tubes are blocked.' Tubal ligation works by blocking the fallopian tubes, preventing sperm from reaching the egg for fertilization. Choice A is incorrect because prostaglandins are not released from the cut fallopian tubes to kill sperm. Choice B is incorrect as the cervical entrance being blocked does not relate to tubal ligation. Choice D is incorrect because tubal ligation does not affect the release of ova from the ovary.

3. Name 4 of the 12 discussed groups at risk for nutritional deficiencies.

• A. Elderly
• B. Low income
• C. Vegans
• D. Chronic disease, alcoholics

Correct answer: A

Rationale: The correct answer is A: Elderly. The other choices provided, low income, vegans, and chronic disease, alcoholics, are also at risk for nutritional deficiencies but the question specifically asks for 4 groups out of the 12 discussed. The 12 groups at risk for nutritional deficiencies include the elderly, low income individuals, vegans, chronic disease, alcoholics, smokers, periods of growth, individuals with medical conditions, physical stress, physiological stress, those on polypharmacy, and those with inadequate intake. The question focuses on identifying 4 out of these 12 groups, making 'Elderly' the correct choice.

4. An emerging technique in screening for Breast Cancer in developing countries like the Philippines is:

• A. Mammography once a year starting at the age of 50
• B. Clinical BSE Once a year
• C. BSE Once a month
• D. Pap smear starting at the age of 18 or earlier if sexually active

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. A healthcare professional is reviewing the laboratory findings of a client who has heart failure. Which of the following findings indicates that the client is experiencing fluid volume excess?

• A. BUN 8 mg/dL
• B. Hgb 15 g/dL
• C. Creatinine 0.8 mg/dL
• D. Sodium 140 mEq/L

Correct answer: A

Rationale: A BUN level of 8 mg/dL indicates fluid volume excess in a client with heart failure. BUN (Blood Urea Nitrogen) levels can be low in fluid overload due to hemodilution, a common occurrence in heart failure. High levels of BUN usually indicate dehydration or impaired renal function, which are not the case in fluid volume excess. Choices B, C, and D are within normal ranges and do not specifically indicate fluid volume excess.

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