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 is a common symptom of vitamin D deficiency?

• A. Hair loss
• B. Night blindness
• C. Bone pain
• D. Rashes

Correct answer: C

Rationale: The correct answer is C: Bone pain. Vitamin D deficiency often leads to bone pain and weakness as it plays a crucial role in maintaining bone health by aiding in the absorption of calcium. Hair loss (choice A) is not a common symptom of vitamin D deficiency. Night blindness (choice B) is typically associated with vitamin A deficiency, not vitamin D deficiency. Rashes (choice D) are not a common symptom of vitamin D deficiency.

3. Integrated management for childhood illness is the universal protocol of care endorsed by WHO and is used by different countries worldwide, including the Philippines. In any case that the nurse classifies the child and categorizes the signs and symptoms in the PINK category, you know that this means:

• A. Urgent referral
• B. Antibiotic Management
• C. Home treatment
• D. Outpatient treatment facility is needed

Correct answer: B

Rationale: When a child is classified under the PINK category in the Integrated Management of Childhood Illness (IMCI) guidelines, it signifies the need for antibiotic management. This category indicates severe signs and symptoms requiring immediate antibiotic treatment to address the underlying infection. Choices A, C, and D are incorrect because the PINK category specifically calls for urgent antibiotic management rather than urgent referral, home treatment, or outpatient treatment facility.

4. A client is being prepared for placement of a catheter for total parenteral nutrition. Which of the following access sites should be planned for catheter insertion?

• A. Left antecubital vein
• B. Right subclavian vein
• C. Right femoral artery
• D. Left arm radial artery

Correct answer: B

Rationale: The correct answer is the Right subclavian vein. When preparing a client for placement of a catheter for total parenteral nutrition, the preferred access site for catheter insertion is the subclavian vein due to its large size, central location, and lower risk of infection compared to peripheral veins. The other options provided (Left antecubital vein, Right femoral artery, and Left arm radial artery) are not suitable access sites for central venous catheter insertion for total parenteral nutrition.

5. Which vitamin's recommended dietary allowance (RDA) is significantly increased during pregnancy?

• A. Folate
• B. Thiamine (B1)
• C. Riboflavin (B2)
• D. Niacin (B3)

Correct answer: A

Rationale: The correct answer is A: Folate. During pregnancy, the recommended dietary allowance (RDA) for folate is significantly increased to support fetal development and prevent neural tube defects and other congenital anomalies. Folate plays a crucial role in DNA synthesis and cell growth, making it essential for the rapidly dividing cells of the developing fetus. Thiamine (B1), Riboflavin (B2), and Niacin (B3) are important vitamins, but their RDAs do not undergo as significant an increase during pregnancy as folate's RDA does.

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