Nursing Elites

1. A client with heart failure is being taught by a nurse on reducing daily sodium intake. Which factor is most crucial in determining the client’s ability to learn new dietary habits?

• A. The client's involvement in planning the change
• B. The cost of the dietary changes
• C. The availability of low-sodium foods
• D. The client’s previous dietary knowledge

Correct answer: D

Rationale: The client’s previous dietary knowledge is the most critical factor in determining the ability to learn new dietary habits. Understanding the client's existing dietary knowledge helps tailor the teaching to build upon what they already know. While client involvement in planning changes can increase adherence and motivation, the foundational knowledge is essential for effective learning. The cost of dietary changes and the availability of low-sodium foods are important considerations but not as crucial as the client's existing knowledge.

2. A community health nurse is caring for a group of families. The nurse should identify which of the following families is experiencing a maturational loss?

• A. A family whose only child recently died due to cancer.
• B. A family whose head of household lost her job.
• C. A family whose house was destroyed in a fire.
• D. A family whose oldest child is moving away for college.

Correct answer: D

Rationale: The correct answer is D because maturational loss is related to developmental changes, such as children leaving for college. This type of loss is tied to the normal life transitions of individuals and can lead to feelings of grief and adjustment. Choices A, B, and C represent different types of losses. Choice A involves a traumatic loss of a child due to illness, choice B involves a financial loss impacting the head of household's job, and choice C involves a material loss due to a fire incident. While these losses are significant, they do not specifically relate to maturational loss, which is associated with expected life stage transitions.

3. A healthcare professional is planning to document care provided for a client. Which of the following abbreviations should the professional use?

• A. PC for after meals
• B. QD for every day
• C. BID for twice a day
• D. PRN for as needed

Correct answer: A

Rationale: The correct answer is A: PC for after meals. PC stands for 'post cibum,' which is the appropriate abbreviation for 'after meals' in medical documentation. Choices B, QD, and C, BID, represent 'every day' and 'twice a day,' respectively, which are not specific to meal times. Choice D, PRN, signifies 'as needed,' which is also not related to meal timings. Therefore, for documenting care provided after meals, the most suitable abbreviation is PC.

4. In an emergency situation, the charge nurse on the night shift at an urgent care center has to deal with admitting clients of higher acuity than usual due to a large fire in the area. Which style of leadership and decision-making would be best in this circumstance?

• A. Assume a decision-making role
• B. Seek input from staff
• C. Use a non-directive approach
• D. Shared decision-making with others

Correct answer: A

Rationale: In an emergency situation such as dealing with patients of higher acuity due to a large fire, it is crucial for the charge nurse to assume a decision-making role. This style of leadership allows for quick and efficient decision-making to manage the increased acuity of patients effectively. Seeking input from staff (Choice B) may delay critical decisions needed in emergencies. Using a non-directive approach (Choice C) or shared decision-making with others (Choice D) may not be suitable in urgent situations where immediate actions are required to address the high acuity of patients.

5. A nurse is caring for an adolescent client who has full-thickness burns on his leg. The client expresses concern about his future. Which of the following is a therapeutic response by the nurse?

• A. “You’re concerned about what will happen when you leave the hospital?”
• B. “If you work hard on your physical therapy, you won’t need to worry.”
• C. “You shouldn’t worry about the future so you can concentrate on getting well.”
• D. “Why are you concerned even though everyone is here to help you?”

Correct answer: A

Rationale: The correct response is A, “You’re concerned about what will happen when you leave the hospital?” This response acknowledges the client's concerns about the future, validating their feelings and encouraging open communication. It shows empathy and allows the client to express their worries. Choice B minimizes the client's concerns by suggesting that they won't need to worry if they work hard on physical therapy, which may invalidate their emotions. Choice C dismisses the client's worry, implying that they should ignore their concerns to focus on getting well. Choice D uses a confrontational approach by questioning the client's concerns, which may discourage open communication and make the client feel defensive.

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