Nursing Elites

1. A client is at risk for excess fluid volume. Which nursing intervention ensures the most accurate monitoring of the client’s fluid status?

• A. Measuring and recording fluid intake and output
• B. Weighing the client daily at the same time each day
• C. Assessing the client’s vital signs every 4 hours
• D. Checking the client’s lungs for crackles during every shift

Correct answer: B

Rationale: Weighing the client daily at the same time each day is the most accurate method for monitoring fluid balance. Changes in body weight can reflect fluid retention or loss. Measuring and recording fluid intake and output (Choice A) is important but may not provide immediate changes in fluid status. Assessing vital signs (Choice C) can offer some information but may not be as specific to fluid status as daily weighing. Checking the client's lungs for crackles (Choice D) is more related to assessing respiratory status rather than direct fluid monitoring.

2. In supply and equipment management, what is the FIRST step in the procurement process?

• A. Keep hand receipts up to date
• B. Establish requirements
• C. Requisition supplies and equipment through the proper channels
• D. Properly receive, inspect, and store required items

Correct answer: B

Rationale: The correct answer is B: Establish requirements. In the procurement process, the initial step involves determining and establishing the requirements for the supplies and equipment needed. This step is crucial as it sets the foundation for the entire procurement process by outlining the specific needs and specifications. Choice A, 'Keep hand receipts up to date,' is not the first step but rather a later administrative task. Choice C, 'Requisition supplies and equipment through the proper channels,' comes after establishing requirements. Choice D, 'Properly receive, inspect, and store required items,' is the final step in the procurement process, focusing on the physical receipt and handling of the procured items.

3. Listed below are five categories that identify the responsibilities of the practical nurse manager in personnel management. Which of these categories is most appropriate for the task 'Educate soldiers in the history and traditions of the service'?

• A. Accountability
• B. Personal/professional development
• C. Individual training
• D. Military appearance/physical condition

Correct answer: B

Rationale: The appropriate category for the task 'Educate soldiers in the history and traditions of the service' is 'Personal/professional development.' This category involves educating individuals in various aspects, including history and traditions, to enhance their overall growth and knowledge. Choices A, C, and D are incorrect because 'Accountability' focuses on responsibility and answerability, 'Individual training' refers to specific skill development, and 'Military appearance/physical condition' pertains to physical fitness and presentation, none of which directly align with educating soldiers in history and traditions.

4. Which of the following is a primary intervention for managing hyperphosphatemia?

• A. Increasing calcium intake
• B. Increasing phosphorus intake
• C. Decreasing calcium intake
• D. Administering phosphate binders

Correct answer: D

Rationale: The correct answer is D, administering phosphate binders. Phosphate binders are a primary intervention for managing hyperphosphatemia as they help by binding phosphorus in the gut, preventing its absorption. Increasing calcium intake (choice A) or phosphorus intake (choice B) would exacerbate hyperphosphatemia. Decreasing calcium intake (choice C) is not a primary intervention for managing high phosphorus levels.

5. A patient with chronic renal failure should avoid which of the following?

• A. Potassium
• B. Calcium
• C. Iron
• D. Zinc

Correct answer: A

Rationale: Patients with chronic renal failure should avoid potassium due to impaired kidney function. The kidneys play a crucial role in regulating potassium levels in the body. In renal failure, the kidneys may not be able to excrete excess potassium effectively, leading to hyperkalemia. Calcium, iron, and zinc are not typically restricted in chronic renal failure unless there are specific individual circumstances, making them incorrect choices.

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