Nursing Elites

1. In patients with heart failure, which type of diet is most recommended?

• A. High-sodium
• B. Low-sodium
• C. High-fat
• D. Low-carbohydrate

Correct answer: B

Rationale: A low-sodium diet is most recommended for patients with heart failure. This type of diet helps manage fluid retention by reducing the amount of sodium in the body, which in turn decreases the workload on the heart. High-sodium diets can lead to fluid retention and worsen heart failure symptoms. High-fat and low-carbohydrate diets are not specifically recommended for heart failure patients as the focus is primarily on controlling sodium intake.

2. A client is admitted to the hospital with the diagnosis of a right-sided brain attack (CVA). The client is right-handed. Which task will be most difficult for this client?

• A. Eating meals
• B. Writing letters
• C. Combing the hair
• D. Dressing every morning

Correct answer: B

Rationale: The correct answer is B: Writing letters. Writing requires fine motor skills, which are often impaired in a right-handed person with a right-sided CVA. Eating meals (choice A), combing the hair (choice C), and dressing every morning (choice D) involve gross motor skills and may not be as challenging for a right-handed individual with a right-sided CVA compared to the fine motor skill required for writing.

3. The nurse is caring for the client one (1) day postoperative sigmoid colostomy operation. Which independent nursing intervention should the nurse implement?

• A. Change the infusion rate of the intravenous fluid
• B. Encourage the client to discuss his or her feelings
• C. Administer opioid narcotic medications for pain management
• D. Assist the client out of bed to sit in the chair twice daily

Correct answer: D

Rationale: Assisting the client to sit in a chair is a crucial nursing intervention postoperatively. It helps prevent complications such as thrombosis, pneumonia, and pressure ulcers by promoting circulation and aiding in recovery. Changing the infusion rate of the intravenous fluid would require a physician's order and is not within the nurse's independent scope of practice. Encouraging the client to discuss feelings and administering medications for pain management are important interventions but may not be as immediately necessary as assisting the client in mobilizing early postoperatively.

4. Which outcome should the nurse identify for the client diagnosed with fluid volume excess?

• A. The client will void a minimum of 30 mL per hour
• B. The client will have elastic skin turgor
• C. The client will have no adventitious breath sounds
• D. The client will have a serum creatinine of 1.4 mg/dL

Correct answer: C

Rationale: The correct outcome for a client diagnosed with fluid volume excess is the absence of adventitious breath sounds. This indicates that fluid is not accumulating in the lungs, a crucial sign in managing fluid volume excess. Choices A, B, and D are incorrect because voiding a specific amount of urine, having elastic skin turgor, and a serum creatinine level do not directly relate to managing fluid volume excess.

5. Students in the resident M6 Practical Nurse Course are expected to achieve entry-level competencies for which of the following?

• A. Medical-surgical nursing
• B. Obstetrics and newborn nursing
• C. Pediatric nursing
• D. Trauma nursing

Correct answer: A

Rationale: The correct answer is A: Medical-surgical nursing. In the resident M6 Practical Nurse Course, students are expected to achieve entry-level competencies in medical-surgical nursing, which includes caring for adult patients who are acutely ill or recovering from surgery. Obstetrics and newborn nursing (choice B), pediatric nursing (choice C), and trauma nursing (choice D) are specialized areas that may not be covered in the entry-level competencies of the practical nurse course.

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