Nursing Elites

1. A 39-year-old woman presents for treatment of excessive vaginal bleeding after giving birth to twins one week ago. Which nursing diagnosis is most appropriate in this situation?

• A. Knowledge Deficit related to post-partum blood loss
• B. Self-Care Deficit related to post-partum neglect
• C. Fluid Volume Deficit related to post-partum hemorrhage
• D. Body Image Disturbance related to body changes after delivery

Correct answer: C

Rationale: The correct nursing diagnosis in this situation is 'Fluid Volume Deficit related to post-partum hemorrhage.' Post-partum hemorrhage can lead to excessive bleeding, putting the client at risk of fluid volume deficit due to the loss of blood volume. This diagnosis is most appropriate as it addresses the immediate concern of fluid loss. 'Knowledge Deficit related to post-partum blood loss' (Choice A) is incorrect as the priority in this case is addressing the physical issue of fluid volume deficit rather than knowledge deficit. 'Self-Care Deficit related to post-partum neglect' (Choice B) is not relevant to the situation described. 'Body Image Disturbance related to body changes after delivery' (Choice D) is not the most appropriate nursing diagnosis in this context where the primary concern is fluid volume deficit due to post-partum hemorrhage.

2. A patient with bipolar disorder asks the nurse, "Why did I get this illness? I don't want to be sick."? The nurse would best respond with:

• A. People who develop mental illnesses often had a very traumatic childhood experience.
• B. There is some evidence that contracting a virus during childhood can lead to mental disorders.
• C. Sometimes people with mental illness have an overactive immune system.
• D. We don't fully understand the cause, but mental illnesses do seem to run in the family.

Correct answer: D

Rationale: The correct response is, 'We don't fully understand the cause, but mental illnesses do seem to run in the family.' Current research suggests that while genetics play a role in the development of mental illnesses like bipolar disorder, it is not the sole factor. Environmental influences, life experiences, and other non-genetic factors also contribute significantly to the manifestation of mental disorders. Choices A, B, and C provide incorrect information that is not supported by current research. Traumatic childhood experiences, contracting a virus during childhood, and an overactive immune system are not established causes of bipolar disorder or mental illnesses in general.

3. Who owns a patient's x-rays?

• A. The patient
• B. The doctor
• C. The facility that performed the procedure
• D. None of the above

Correct answer: C

Rationale: X-rays are typically owned by the facility that conducts the procedure, not the patient or the doctor. The facility that performs the procedure is responsible for maintaining and storing the x-rays as part of the patient's medical records. The patient does not own the x-rays since they are part of their medical record and not a physical possession. The doctor also does not own the x-rays as they are generated as a result of the medical procedure conducted at the facility, making choice C the correct answer.

4. A client is receiving education on cholesterol. Which of the following statements from the client indicates the need for further teaching?

• A. I would like my HDL levels to be over 50.
• B. It is better for me to have high HDL levels and low LDL levels.
• C. It is better for me to have high LDL levels and low HDL levels.
• D. My goal is to get my total cholesterol below 200.

Correct answer: C

Rationale: The correct answer is, 'It is better for me to have high LDL levels and low HDL levels.' This statement indicates a need for further teaching because high LDL levels contribute to atherosclerosis, while high HDL levels can protect against heart disease. The client should understand the importance of lowering LDL levels and increasing HDL levels to maintain good heart health. Choice A is correct as desiring HDL levels over 50 is a positive goal. Choice B is correct as it reflects the ideal scenario of high HDL and low LDL levels. Choice D is correct as a total cholesterol below 200 is a common goal for heart health. Therefore, Choice C is incorrect as it suggests an opposite and unhealthy relationship between LDL and HDL levels.

5. During a health history assessment of a new patient, which data should be the focus for patient teaching?

• A. Age and gender
• B. Saturated fat intake
• C. Hispanic/Latino ethnicity
• D. Family history of diabetes

Correct answer: B

Rationale: The correct answer is saturated fat intake. Behaviors play a crucial role in health outcomes, and saturated fat intake is a modifiable behavior that can significantly impact a patient's health. By focusing on educating the patient about reducing saturated fat intake, the healthcare provider can empower the patient to make positive changes. While age, gender, ethnicity, and family history are important factors in understanding a patient's health status, they are not behaviors that can be directly modified through patient teaching. Therefore, these factors are essential for developing an individualized care plan but are not the primary focus of patient teaching. Saturated fat intake directly relates to dietary habits, which can be altered through education and support to promote better health outcomes.

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