Nursing Elites

1. A client with stomatitis is receiving teaching from a nurse. Which of the following client statements indicates a need for further teaching?

• A. "I will drink liquids through a straw."?
• B. "I will season foods with dried spices before cooking."?
• C. "I will rinse my mouth with baking soda and water frequently."?
• D. "I will eat frozen bananas as a snack."?

Correct answer: C

Rationale: The correct answer is, "I will rinse my mouth with baking soda and water frequently."? Stomatitis is an inflammation of the mucous lining in the mouth, and rinsing with baking soda and water can be too abrasive and further irritate the condition. Choices A, B, and D are appropriate self-care measures for a client with stomatitis and do not indicate a need for further teaching.

2. The nutrient facts panel was established by the USDA and the FDA to improve health and well-being by enhancing nutritional knowledge. Nutrient content claims describe a relationship between a food or food component and reduced risk of a disease or health-related condition.

• A. Both statements are true.
• B. Both statements are false.
• C. The first statement is true; the second is false.
• D. The first statement is false; the second is true.

Correct answer: C

Rationale: The correct answer is C. The first statement is true as the nutrient facts panel was indeed established by the USDA and the FDA to improve health and well-being by enhancing nutritional knowledge. However, the second statement is false. Nutrient content claims actually refer to the amount of a nutrient in a food, not to the relationship between a food and disease risk. Therefore, the second statement is incorrect, making choice C the correct option. Choice A is incorrect because the second statement is false. Choice B is incorrect as the first statement is true. Choice D is incorrect because the second statement is false.

3. What nursing diagnosis would be most appropriate for a patient with heart failure?

• A. risk for infection
• B. fluid volume excess
• C. impaired body temperature
• D. ineffective airway clearance

Correct answer: B

Rationale: The most appropriate nursing diagnosis for a patient with heart failure is 'fluid volume excess.' In heart failure, the heart's reduced pumping ability leads to fluid retention, causing an excess of fluid in the body. This can result in symptoms such as edema, shortness of breath, and weight gain. 'Risk for infection,' 'impaired body temperature,' and 'ineffective airway clearance' are not the most appropriate nursing diagnoses for a patient with heart failure as they do not directly relate to the pathophysiology and common issues seen in heart failure patients.

4. Which type of bath would you recommend for a patient experiencing pruritus?

• A. Saline
• B. Colloidal (oatmeal)
• C. Water
• D. Sodium bicarbonate

Correct answer: B

Rationale: The best choice for a pruritus (itching) patient is a colloidal (oatmeal) bath, as it is known for its soothing effect on itchy, irritated skin. Saline, water, and sodium bicarbonate baths may not provide the same level of relief for pruritus. The nursing care should involve comprehensive assessments and appropriate interventions to optimize patient outcomes. In this case, a colloidal bath is the most suitable intervention for a patient experiencing pruritus.

5. A nurse is teaching a nutrition class for clients who have type 2 diabetes mellitus. Which of the following statements should the nurse include about management of acute illness?

• A. Consume carbs every 3-4 hrs
• B. Decrease fluid intake to 1000 mL per day
• C. Monitor blood glucose twice per day
• D. Check urine for ketones every 24 hrs

Correct answer: A

Rationale: The correct statement is to 'Consume carbs every 3-4 hours.' During acute illness, it is important to maintain a consistent carbohydrate intake to help manage blood glucose levels for clients with type 2 diabetes. This frequent consumption can prevent hypoglycemia and provide energy needed during illness. Decreasing fluid intake (choice B) is not recommended during acute illness, as hydration is crucial to prevent complications. Monitoring blood glucose (choice C) more frequently than twice a day is necessary during acute illness. Checking urine for ketones (choice D) should be done more frequently than once every 24 hours during illness to monitor for diabetic ketoacidosis.

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