Nursing Elites

1. The mechanism behind most CKD in patients without diabetes is mediated by:

• A. enzyme systems
• B. immune systems
• C. catabolic systems
• D. hormonal systems

Correct answer: B

Rationale: In non-diabetic patients, CKD is often mediated by immune system responses. Chronic inflammation triggered by immune system dysfunction can contribute to progressive kidney damage. Therefore, the correct answer is 'immune systems.' Choices A, C, and D are incorrect because CKD in non-diabetic patients is primarily associated with immune system abnormalities rather than enzyme, catabolic, or hormonal systems.

2. 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.

3. Which gluten-free food choice would be most appropriate for a patient with celiac disease?

• A. Scalloped potatoes
• B. Oatmeal
• C. Eggs
• D. Tortillas

Correct answer: C

Rationale: Eggs are a safe food choice for individuals with celiac disease as they are naturally gluten-free. Scalloped potatoes often contain flour in the sauce, which might contain gluten. Oatmeal can be a subject of debate due to possible cross-contamination during processing, so it might not be safe unless labeled gluten-free. Tortillas are typically made from wheat flour containing gluten, but gluten-free versions are available. However, eggs are universally gluten-free, making them the best choice for individuals with celiac disease.

4. A client is prescribed a 1500-calorie diet. Thirty percent of the calories are to be derived from fat. How many grams of fat should the nurse tell the client to consume per day? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

• A. 21
• B. 49
• C. 60
• D. 50

Correct answer: D

Rationale: To calculate the grams of fat, first, determine the calories from fat by multiplying the total calorie intake (1500 calories) by the percentage of calories from fat (30%), which equals 450 calories from fat. Since 1 gram of fat is equivalent to 9 calories, divide the total calories from fat (450) by the calories in 1 gram of fat (9) to get the answer in grams, which is 50. Therefore, the client should consume 50 grams of fat per day. Choice A (21), Choice B (49), and Choice C (60) are incorrect as they do not reflect the accurate calculation based on the given information.

5. A client who has dumping syndrome following a hemi-colectomy should avoid which of the following foods when receiving nutritional teaching from a nurse?

• A. Rice
• B. Poached eggs
• C. Fresh apples
• D. White bread

Correct answer: C

Rationale: Fresh apples should be avoided by a client with dumping syndrome following a hemi-colectomy because they are high in fiber and can exacerbate gastrointestinal symptoms such as diarrhea and bloating. Rice and poached eggs are good options as they are easily digestible and less likely to trigger dumping syndrome symptoms. White bread is also preferable over whole grain bread due to its lower fiber content, making it a better choice for individuals with dumping syndrome.

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