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. The RDA for iron is higher in premenopausal women than for men or postmenopausal women because of the blood loss during menstruation.

• A. Both the statement and the reason are correct and related.
• B. Both the statement and the reason are correct but are not related.
• C. The statement is correct, but the reason is not correct.
• D. The statement is not correct, but the reason is correct.

Correct answer: A

Rationale: Both the statement and the reason are correct and related. The Institute of Medicine (IOM) recommends 18 mg of iron per day for women 19 to 50 years old, 8 mg/day for women 51 years old and older, and men 19 years old and older. During menstruation, women lose blood containing iron, leading to a higher iron requirement in premenopausal women compared to men or postmenopausal women. This increased demand aims to replenish the iron lost during this physiological process. Therefore, the statement and reason are directly linked, explaining why the RDA for iron is higher in premenopausal women than in men or postmenopausal women. Choices B, C, and D are incorrect as they do not accurately assess the relationship between the statement and the reason provided in the question.

3. A dietitian tells you that you are not consuming enough calories. Which of the following nutrients could you add to your diet to increase your energy intake?

• A. fiber
• B. water
• C. protein
• D. vitamins

Correct answer: C

Rationale: Corrected Rationale: Protein provides 4 kcal per gram, making it a good source of energy to increase caloric intake. While fiber and water are important for other aspects of health, they do not provide energy like protein does. Vitamins are essential for various bodily functions but do not contribute directly to caloric intake.

4. Patients with this chronic nutrient deficiency may feel tired, weak, and irritable while being unable to pinpoint why. Hypertension, heart attack, stroke, kidney stones, and osteoporosis are associated with the chronic deficiency of which nutrient?

• A. Zinc
• B. Iron
• C. Sodium
• D. Potassium

Correct answer: D

Rationale: The correct answer is D: Potassium. Chronic potassium deficiency can lead to hypertension, heart attack, stroke, kidney stones, and osteoporosis. Patients experiencing this deficiency may feel tired, weak, and irritable without knowing the cause. Choice A (Zinc) is incorrect as zinc deficiency presents with different symptoms. Choice B (Iron) deficiency is associated with anemia symptoms, not the conditions listed. Choice C (Sodium) deficiency typically manifests as muscle cramps, weakness, and confusion, not the conditions described in the question.

5. In order to establish a therapeutic relationship with the client, the nurse must first have:

• A. Self awareness C. Self acceptance
• B. Self understanding D. Self motivation
• C.
• D.

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.

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