Nursing Elites

1. A nurse is caring for a client following an acute myocardial infarction who is concerned about fatigue. What is the best strategy to promote independence in self-care?

• A. Instruct the client to remain in bed until the fatigue resolves
• B. Encourage the client to gradually resume self-care tasks with frequent rest periods
• C. Assign assistive personnel to perform all self-care tasks for the client
• D. Ask the client's family to assist with self-care

Correct answer: B

Rationale: Encouraging the client to gradually resume self-care tasks with frequent rest periods is the best strategy to promote independence while managing fatigue. This approach allows the client to regain confidence in their abilities and fosters independence. Option A is incorrect as prolonged bed rest can lead to deconditioning and worsen fatigue. Option C is not promoting independence as it involves delegating all self-care tasks to others. Option D involves family assistance, which may be helpful but does not directly promote the client's independence in self-care.

2. A charge nurse is teaching new staff members about factors that increase a client's risk of becoming violent. Which of the following risk factors should the nurse include as the best predictor of future violence?

• A. Experiencing delusions.
• B. Male gender.
• C. Previous violent behavior.
• D. A history of being in prison.

Correct answer: C

Rationale: The correct answer is C: Previous violent behavior. This is considered the best predictor of future violent actions as individuals who have a history of violent behavior are more likely to engage in violent acts again. Option A, experiencing delusions, although it can impact behavior, is not as strong of a predictor as past violent behavior. Option B, male gender, is a demographic factor but not as specific or predictive as a history of violence. Option D, a history of being in prison, may indicate past behavior but is not directly linked to future violent actions as a known history of violence.

3. What are the common signs and symptoms of dehydration in the elderly?

• A. Dry mouth, confusion, and decreased skin turgor
• B. Increased heart rate and muscle cramps
• C. Fever, rapid breathing, and increased urine output
• D. Increased thirst and difficulty walking

Correct answer: A

Rationale: Corrected Rationale: Dehydration in the elderly is often signaled by dry mouth, confusion, and decreased skin turgor due to reduced fluid intake. Choice A is the correct answer as these are common signs and symptoms of dehydration in the elderly.\nIncorrect Rationales: Option B (Increased heart rate and muscle cramps) are more associated with conditions like hyperthyroidism or electrolyte imbalances rather than dehydration. Option C (Fever, rapid breathing, and increased urine output) are signs of other medical conditions such as infections or diabetes insipidus. Option D (Increased thirst and difficulty walking) can be seen in various situations but are not specific signs of dehydration in the elderly.

4. A nurse is reinforcing teaching about ways to reduce solid fat consumption with a client who has an elevated cholesterol level. Which of the following instructions should the nurse include?

• A. Use oils with trans fats
• B. Choose lean cuts of beef
• C. Avoid purchasing beef that is a loin cut
• D. Purchase chicken instead of lamb

Correct answer: B

Rationale: The correct answer is B: 'Choose lean cuts of beef.' Selecting lean cuts of beef is crucial in reducing solid fat consumption for individuals with high cholesterol levels. Lean cuts contain less saturated fat compared to fatty cuts, thus aiding in managing cholesterol levels. Option A is incorrect as oils with trans fats should be avoided since they contribute to unhealthy fats. Option C is not directly related to reducing solid fat consumption. Option D, while suggesting a leaner meat option, does not address the issue of solid fat consumption as directly as choosing lean cuts of beef.

5. What are the key differences between systolic and diastolic heart failure?

• A. Systolic: Reduced ejection fraction; Diastolic: Preserved ejection fraction
• B. Systolic: Preserved ejection fraction; Diastolic: Reduced ejection fraction
• C. Systolic: Right-sided heart failure; Diastolic: Left-sided heart failure
• D. Systolic: Pulmonary congestion; Diastolic: Systemic congestion

Correct answer: A

Rationale: The correct answer is A. Systolic heart failure is characterized by reduced ejection fraction, meaning the heart is not pumping effectively. Diastolic heart failure, on the other hand, is characterized by preserved ejection fraction, indicating that the heart has difficulty relaxing and filling properly. Choices B, C, and D are incorrect because they do not accurately describe the key differences between systolic and diastolic heart failure.

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