Nursing Elites

1. When does the nurse act as a client advocate?

• A. Pulling the curtain around the client's bed while changing a dressing
• B. Contacting the health care provider to request a meeting for the client
• C. Ensuring access to medical information by appropriate personnel only
• D. All of the above

Correct answer: D

Rationale: The correct answer is D, 'All of the above.' Acting as a client advocate involves various actions to protect the client's rights and well-being. Pulling the curtain around the client's bed while changing a dressing ensures privacy and dignity. Contacting the health care provider to request a meeting for the client facilitates communication and addresses the client's needs. Ensuring access to medical information by appropriate personnel only safeguards the client's confidentiality and privacy. Therefore, all the actions mentioned in choices A, B, and C are examples of a nurse acting as a client advocate, making D the correct answer.

2. A nurse is caring for a client with a diagnosis of catatonic schizophrenia. What clinical finding does the nurse expect the client to exhibit?

• A. Crying
• B. Self-mutilation
• C. Immobile posturing
• D. Repetitive activities

Correct answer: C

Rationale: In catatonic schizophrenia, clients commonly exhibit immobile posturing, where they may maintain a fixed position for extended periods. This could include holding rigid poses or remaining motionless. Choice A, 'Crying,' is not typically associated with catatonic schizophrenia. Choice B, 'Self-mutilation,' refers to a different behavior seen in some mental health conditions but is not a characteristic feature of catatonic schizophrenia. Choice D, 'Repetitive activities,' does not align with the typical presentation of catatonic schizophrenia, which is characterized by motor abnormalities such as immobility rather than engaging in purposeful repetitive movements.

3. The nurse has given post-procedure instructions to a client who underwent a colonoscopy. Evaluation of learning would be evident if the client makes which statement(s)?

• A. All of the above
• B. “My abdominal muscles may be tender because of the procedure.”
• C. “My diet should be light at first, and then I can progress to a regular diet.”
• D. “It is normal to feel gassy or bloated for a short while after the procedure.”

Correct answer: A

Rationale: The correct answer is A: "All of the above." Evaluation of learning after a colonoscopy would be evident if the client mentions all the statements provided. Mild tenderness in the abdominal muscles, starting with a light diet and progressing to a regular diet, and experiencing gas or bloating temporarily are all expected after a colonoscopy. Therefore, all the statements are correct in demonstrating the client's understanding of the post-procedure instructions. Choices B, C, and D provide accurate information about the expected outcomes following a colonoscopy, making them incorrect answers individually but correct when combined as option A.

4. For a patient with a history of liver disease, which type of diet is most appropriate?

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

Correct answer: D

Rationale: For a patient with a history of liver disease, a low-fat diet is most appropriate. Liver disease can impair fat metabolism, leading to fat accumulation in the liver cells and worsening the condition. A low-fat diet helps reduce stress on the liver and manage symptoms associated with liver disease. High-protein diets may not be suitable for individuals with liver disease as they can increase the risk of hepatic encephalopathy. High-carbohydrate diets may lead to insulin resistance and fat accumulation in the liver. While protein restriction may be necessary in some cases, a balanced intake of high-quality protein is essential for maintaining muscle mass and overall health, making a low-protein diet not the most appropriate choice for all patients with liver disease.

5. Which of the following describes the four-step method of assessment, planning, implementation, and evaluation?

• A. It is a problem-focused process of continued nursing care
• B. It is an open-ended process of continued nursing care
• C. It is a circular process of continued nursing care
• D. It is a trial-and-error process of continued nursing care

Correct answer: C

Rationale: The correct answer is C: 'It is a circular process of continued nursing care.' The four-step method of assessment, planning, implementation, and evaluation in nursing is a continuous and cyclical process. Choice A is incorrect because the method is not solely problem-focused; it involves a comprehensive approach. Choice B is incorrect as it does not capture the cyclical nature of the process. Choice D is incorrect as the method is systematic and not based on trial-and-error but rather evidence-based practice.

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