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The nurse teaches a diabetic client that diet plays a crucial role in managing diabetes mellitus. When evaluating dietary intake, the nurse knows the client is eating the right foods if total daily caloric intake consists of:
- A. 30% to 35% carbohydrate, 40% fat, and 25% to 30% protein
- B. 40% to 45% carbohydrate, 40% fat, and 15% to 20% protein
- C. 50% to 55% carbohydrate, 35% fat, and 10% to 15% protein
- D. 55% to 60% carbohydrate, 30% fat and 10% to 15% protein
Correct Answer: A
Rationale: In managing diabetes mellitus, one of the key principles is proper macronutrient distribution in the diet. The recommended dietary intake for a diabetic client typically includes a moderate amount of carbohydrates (30% to 35% of total calories) in order to help control blood sugar levels. Including higher amounts of fat (around 40%) can be beneficial in managing this condition as well. Adequate protein intake (25% to 30%) is also important for overall health and satiety. This balanced macronutrient distribution helps in maintaining stable blood sugar levels throughout the day, supporting optimal diabetes management.
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Which is the most appropriate nursing diagnosis for the child with acute glomerulonephritis?
- A. Risk for Injury related to malignant process and treatment
- B. Fluid Volume Deficit related to excessive losses
- C. Fluid Volume Excess related to decreased plasma filtration
- D. Fluid Volume Excess related to fluid accumulation in tissues and third spaces
Correct Answer:
Rationale: Acute glomerulonephritis is characterized by inflammation of the glomeruli in the kidneys, leading to decreased plasma filtration. As a result, fluid volume excess occurs due to impaired kidney function in regulating the fluid balance. Symptoms may include hypertension, edema, weight gain, and oliguria. Therefore, the most appropriate nursing diagnosis for a child with acute glomerulonephritis would be "Fluid Volume Excess related to decreased plasma filtration". This diagnosis focuses on the pathophysiological process of the condition and helps guide nursing interventions aimed at managing fluid volume overload.
Which is a function of brown adipose tissue (BAT) in the newborn?
- A. Provides ready source of calories in the newborn period
- B. Insulates the body against lowered environmental temperature
- C. Protects the newborn from injury during the birth process
- D. Generates heat for distribution to other parts of body
Correct Answer: D
Rationale: Brown adipose tissue (BAT) is specialized adipose tissue found in newborns and hibernating mammals, whose primary function is to generate heat through non-shivering thermogenesis. This heat generation is essential for maintaining body temperature in newborns, especially as they have a larger surface area-to-volume ratio, which results in greater heat loss compared to adults. BAT produces heat by metabolizing stored lipids and disrupting the normal process of cellular respiration, leading to the production of heat instead of ATP. The heat generated by BAT is then distributed throughout the body to help maintain a stable core body temperature in newborns, who are not yet able to regulate their body temperature as effectively as adults.
Alveolar type of rhabdomyosarcoma accounts for approximately 1/3 of all cases of pediatric RMS and carries the poorest prognosis. Of the following, the MOST common site of involvement by alveolar type RMS is
- A. orbit
- B. middle ear
- C. extremities
- D. bladder
Correct Answer: C
Rationale: Extremities are the most common site for alveolar rhabdomyosarcoma.
Which of the following would be the most appropriate nursing intervention when caring for a client with a fractured rib?
- A. Apply immobilization device after examination by physician
- B. Discourage taking deep breaths if breathing is painful
- C. Advise against using analgesics and regional nerve blocks
- D. Encouraged increased fluid intake if pulmonary contusion exists
Correct Answer: A
Rationale: Applying an immobilization device, such as a rib belt or rib binder, is a common nursing intervention for a client with a fractured rib. However, it is essential to first ensure that the client is examined by a physician to confirm the diagnosis and assess the severity of the fracture. Immobilizing the area helps reduce pain, support the chest wall, and promote healing by limiting movement that can further irritate the injured rib. Additionally, the physician's assessment is crucial for determining the appropriate treatment plan and ruling out any complications that may require further medical intervention.
A first-time mother brings in her 5-day-old baby for a well-child visit. The baby weighs 7 lb 5 oz, down from 7 lb 10 oz at discharge. The nurse's best response is:
- A. I will notify the doctor about this weight loss.
- B. Newborns can lose up to 10% of their birth weight and regain it by 2 weeks of age.
- C. I can tell you are a first-time mother; don't worry.
- D. Maybe the baby isn't getting enough milk. How often are you feeding?
Correct Answer: B
Rationale: A small weight loss is normal in the first week of life; infants typically regain their birth weight by 2 weeks.