Nursing Elites

1. A client with pre-dialysis end-stage kidney disease is being taught about diet. Which of the following instructions should the nurse include?

• A. Increase intake of dietary phosphorus.
• B. Eliminate foods high in protein from your diet.
• C. Reduce intake of foods high in potassium.
• D. Increase intake of sodium-containing foods.

Correct answer: C

Rationale: In pre-dialysis end-stage kidney disease, reducing intake of foods high in potassium is crucial as impaired kidney function can lead to potassium buildup in the blood, which can be dangerous. High potassium levels can cause irregular heartbeats and even cardiac arrest. Therefore, advising the client to reduce potassium-rich foods is essential to prevent complications. Choices A, B, and D are incorrect. Increasing dietary phosphorus, eliminating foods high in protein, or increasing sodium-containing foods are not appropriate recommendations for a client with pre-dialysis end-stage kidney disease as they can exacerbate the condition.

2. Protein-energy malnutrition (PEM) may be responsible for the increased incidence of noma and necrotizing ulcerative gingivitis (NUG) because these conditions are associated with depressed immune responses caused by nutritional deficiencies.

• 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: The corrected question highlights that protein-energy malnutrition weakens the immune system, making individuals more susceptible to conditions like noma and NUG, which are linked to compromised immunity. Choice A is correct because the statement and reason are both accurate and directly related. Protein-energy malnutrition does result in depressed immune responses, which can predispose individuals to noma and NUG. Choice B is incorrect because the statement and reason are indeed related. Choice C is incorrect as both the statement and reason are accurate. Choice D is also incorrect as the statement is correct and directly supports the reason provided.

3. Which group is least susceptible to insufficient intake of protein?

• A. The elderly
• B. Individuals with low income
• C. Adults participating in endurance exercise
• D. Patients who are chronically ill

Correct answer: C

Rationale: Adults who participate in endurance exercise are typically more aware of their nutritional needs and have higher protein intake compared to other groups. The rationale behind why the other choices are incorrect is as follows: A: The elderly are often at a higher risk of insufficient protein intake due to various factors such as reduced appetite, dental issues, and decreased muscle mass. B: Individuals with low income may struggle to afford protein-rich foods, making them more susceptible to insufficient protein intake. D: Patients who are chronically ill may have specific dietary restrictions or challenges that can lead to inadequate protein consumption.

4. Which of the following ethical principles refers to the duty to do good?

• A. Beneficence
• B. Fidelity
• C. Veracity
• D. Nonmaleficence

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.

5. Larry, 55 years old, who is suspected of having colorectal cancer, is admitted to the CI. After taking the history and vital signs the physician does which test as a screening test for colorectal cancer.

• A. Barium enema
• B. Carcinoembryonic antigen
• C. Annual digital rectal examination
• D. Proctosigmoidoscopy

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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