Nursing Elites

1. 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.

2. Mr. Bruno asks what the “normal” allowable salt intake is. Your best response to Mr. Bruno is:

• A. 1 tsp of salt/day with iodine and sprinkle of MSG
• B. 5 gms per day or 1 tsp of table salt/day
• C. 1 tbsp of salt/day with some patis and toyo
• D. 1 tsp of salt/day but no patis and toyo

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

3. A nurse is teaching about nutrition to a client who has a new diagnosis of chronic kidney disease. Which of the following recommendations should the nurse include in the teaching?

• A. Increase phosphorus intake
• B. Limit calcium intake
• C. Limit protein intake
• D. Increase potassium intake

Correct answer: C

Rationale: The correct recommendation for a client with chronic kidney disease is to limit protein intake. Excessive protein consumption can strain the kidneys as they work to eliminate waste products from protein metabolism. This can worsen kidney function in individuals with chronic kidney disease. Therefore, limiting protein intake is crucial in managing this condition. Choices A, B, and D are incorrect. Increasing phosphorus intake can be harmful in kidney disease as it can lead to mineral imbalances. Limiting calcium intake is not typically necessary unless the client has specific complications. Increasing potassium intake may also be inappropriate as potassium levels can be affected in kidney disease.

4. What is the glomerular filtration rate for patients with stage 5 chronic kidney disease (CKD)?

• A. Less than 15 mL/min/1.73 m�
• B. Less than 30 mL/min/1.73 m�
• C. Less than 90 mL/min/1.73 m�
• D. Less than 125 mL/min/1.73 m�

Correct answer: A

Rationale: In patients with stage 5 chronic kidney disease (CKD), also known as end-stage renal disease, the kidney function is significantly compromised. This severe condition is characterized by a glomerular filtration rate (GFR) of less than 15 mL/min/1.73 m�, as correctly stated in choice A. Choices B, C, and D suggest higher GFR values, which are not indicative of stage 5 CKD. Specifically, a GFR of less than 30 mL/min/1.73 m� indicates stage 4 CKD, less than 90 mL/min/1.73 m� signifies stage 3 CKD, and a typical healthy individual usually has a GFR of around 125 mL/min/1.73 m�, which is far above the GFR for stage 5 CKD.

5. A client with type 1 diabetes mellitus asks a nurse for a sweetener recommendation. Which of the following recommendations should the nurse make?

• A. Corn syrup
• B. Natural honey
• C. Nonnutritive sugar substitute
• D. Guava nectar

Correct answer: C

Rationale: The correct recommendation for a client with type 1 diabetes mellitus looking for a sweetener is a nonnutritive sugar substitute. Nonnutritive sugar substitutes do not significantly affect blood glucose levels, making them a suitable option for individuals with diabetes. Corn syrup and natural honey are high in sugar and can lead to spikes in blood glucose levels, which is not ideal for someone with diabetes. Guava nectar, while natural, is also high in sugar content and not recommended for individuals with diabetes.

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