Nursing Elites

1. The recommended daily fluid intake of patients maintained using hemodialysis is:

• A. 150 mL plus the volume of urinary output
• B. 500 mL plus the volume of urinary output
• C. 1000 mL plus the volume of urinary output
• D. 1500 mL plus the volume of urinary output

Correct answer: C

Rationale: The correct answer is C: 1000 mL plus the volume of urinary output. Fluid intake is typically restricted in hemodialysis patients to prevent fluid overload. The recommended daily fluid intake for these patients is 1000 mL plus any urinary output. Choice A (150 mL plus the volume of urinary output) is too low and would not provide enough fluid for these patients. Choice B (500 mL plus the volume of urinary output) is also insufficient. Choice D (1500 mL plus the volume of urinary output) is too high and may lead to fluid overload in hemodialysis patients.

2. Each of the following accurately describes aspects of the dietary reference intakes (DRIs) published by the Food and Nutrition Board of the Institute of Medicine (IOM) except one. Which one is the exception?

• A. The DRIs replace the older recommended daily allowances.
• B. Current DRIs attempt to estimate required nutrients to improve long-term health.
• C. DRIs specifically address individuals whose requirements are affected by a disease state.
• D. The DRIs attempt to establish maximum safe levels of tolerance for nutrients.

Correct answer: C

Rationale: The correct answer is C. DRIs do not specifically address individuals with disease states; they are intended for the general healthy population. Choice A is correct because DRIs indeed replace the older recommended daily allowances. Choice B is correct as current DRIs aim to estimate required nutrients to enhance long-term health. Choice D is accurate as DRIs also attempt to establish maximum safe levels of tolerance for nutrients.

3. A patient who is recovering from surgery should increase their intake of which nutrient to promote healing?

• A. Fats
• B. Carbohydrates
• C. Protein
• D. Fiber

Correct answer: C

Rationale: Protein is crucial for tissue repair and recovery after surgery. Proteins provide the building blocks necessary for tissue healing and regeneration. Fats are important for various bodily functions but are not as directly involved in tissue repair as proteins. Carbohydrates provide energy but do not play a primary role in tissue healing. Fiber is essential for digestive health but is not a nutrient that directly promotes tissue repair.

4. A patient is admitted to the emergency room and is found to have proteinuria, a low serum albumin level, edema, and elevated blood lipids. Which condition do these symptoms typically associate with?

• A. Nephrotic syndrome
• B. Acute kidney injury
• C. Rejection of a kidney transplant
• D. Renal colic

Correct answer: A

Rationale: The correct answer is A: Nephrotic syndrome. Nephrotic syndrome is characterized by proteinuria (excess protein in urine), hypoalbuminemia (low serum albumin), edema (swelling due to fluid buildup), and hyperlipidemia (elevated blood lipids). These symptoms occur as a result of damage to the kidneys' filtering units. Acute kidney injury, rejection of a kidney transplant, and renal colic do not present with the same combination of symptoms as nephrotic syndrome. Acute kidney injury typically presents with a sudden decrease in kidney function, resulting in a build-up of waste products in the blood. Rejection of a kidney transplant may present with fever, pain at the transplant site, and changes in urine output. Renal colic usually presents with intense pain in the lower back or side, related to kidney stones.

5. Inadequate intake of vitamin A occurs in lower socioeconomic groups due to a lack of resources to purchase and consume vegetables and fruits.

• 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. Inadequate intake of vitamin A in lower socioeconomic groups is due to a lack of resources to purchase and consume vegetables and fruits. This is supported by the fact that the average intake in the United States meets the Recommended Dietary Allowance (RDA) for vitamin A intake, except in lower socioeconomic groups. These individuals often lack the financial means to buy, prepare, and eat a variety of fruits and vegetables, leading to deficiencies. It's important to note that because vitamin A can be stored in the liver, most adults have sufficient quantities to maintain health. Choices B, C, and D are incorrect because the statement and reason are both accurate and logically connected, as the lack of resources directly impacts the ability to obtain necessary sources of vitamin A.

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