Nursing Elites

1. What is the initial major sign of acute renal failure?

• A. Oliguria
• B. Hematuria
• C. Proteinuria
• D. Glycosuria

Correct answer: A

Rationale: Oliguria, or reduced urine output, is often the initial major sign of acute renal failure. This reduction in urine output indicates that the kidneys are not functioning properly. Hematuria (blood in urine), proteinuria (presence of protein in urine), and glycosuria (presence of glucose in urine) are not typically the initial major signs of acute renal failure. While they may be present in certain conditions, oliguria is the most common and critical indicator of acute renal failure.

2. Because of increasing cases of fluorosis, low levels of fluoride are added to commercial infant formula. Breast milk provides low levels of fluoride.

• A. Both statements are true
• B. Both statements are false
• C. The first statement is true; the second is false
• D. The first statement is false; the second is true

Correct answer: D

Rationale: The first statement is false; fluoride is not added to infant formulas due to the risk of fluorosis. The second statement is true; breast milk contains low levels of fluoride.

3. 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.

4. What physiologic role does calcium play in the body?

• A. Blood clotting, transmission of nerve impulses, muscle contraction and relaxation
• B. Calcium homeostasis, structural integrity of heart muscle
• C. No known metabolic function, caries-preventing properties
• D. ATP energy release; metabolism of fats, carbohydrates, proteins; regulates acid-base balance.

Correct answer: A

Rationale: The correct answer is A: 'Blood clotting, transmission of nerve impulses, muscle contraction and relaxation.' Calcium plays a crucial role in various physiological functions such as blood clotting, transmission of nerve impulses, muscle contraction and relaxation, membrane permeability, and activation of certain enzymes. Choice B is incorrect because while calcium is involved in calcium homeostasis, it is not the only role it plays in the body. Choice C is incorrect as calcium indeed has several known metabolic functions, and it is not solely for preventing caries. Choice D is also incorrect as the functions mentioned are primarily carried out by other nutrients and not specifically by calcium.

5. A group of clients is being instructed by a nurse regarding nutrition. The teaching should state that which of the following groups of foods contains the highest level of carbohydrates?

• A. Milk, eggs, and cheese
• B. Butter, oils, and avocados
• C. Rice, potatoes, and oranges
• D. Chicken, green beans, and apples

Correct answer: C

Rationale: The correct answer is C: Rice, potatoes, and oranges. These foods are rich in carbohydrates. Choice A (Milk, eggs, and cheese) contains minimal carbohydrates as they are primarily sources of protein and fat. Choice B (Butter, oils, and avocados) contains very little to no carbohydrates as they are high in fats. Choice D (Chicken, green beans, and apples) also contains minimal carbohydrates, with protein and fiber being more prominent in these foods.

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