Nursing Elites

1. What dietary alterations should a pregnant client with congenital heart disease expect?

• A. reduced calories and reduced fat
• B. caffeine and sodium restrictions
• C. decreased protein and increased complex carbohydrates
• D. fluid restriction and reduced calories

Correct answer: B

Rationale: In a pregnant client with congenital heart disease, caffeine should be restricted as it can increase heart rate, which is already under stress due to pregnancy. Sodium restrictions may be necessary to prevent fluid retention, which can worsen the client's heart condition. Decreasing calories, fat, protein, or fluid may not be appropriate as these can lead to nutrient deficiencies or inadequate energy intake, which is crucial during pregnancy. Therefore, options A, C, and D are not the expected dietary alterations in the client's diet during pregnancy with congenital heart disease.

2. Once the nurse has made initial rounds and checked all of the assigned clients, which client should be cared for first?

• A. A client who is scheduled for surgery at 1 p.m.
• B. A client in skeletal traction who has just received pain medication
• C. A client scheduled for physical therapy at 11 a.m.
• D. A client who is able to perform activities of daily living independently

Correct answer: A

Rationale: The priority should be given to the client who is scheduled for surgery at 1 p.m. Preparing a client for surgery involves various tasks such as physical and emotional preparation, following healthcare provider instructions, and potential last-minute changes in the surgical schedule. It is crucial to ensure the client is adequately prepared. Providing care to a client who just received pain medication can wait until the medication takes effect. Clients who are independent in performing daily activities and those scheduled for physical therapy later in the morning are not as high a priority as preparing a client for an upcoming surgery. Therefore, the client scheduled for surgery should be cared for first to ensure all necessary preparations are completed.

3. Which of the following indicates a hazard for a client on oxygen therapy?

• A. A 'No Smoking' sign is on the door.
• B. The client is wearing a synthetic gown.
• C. Electrical equipment is grounded.
• D. Matches are removed.

Correct answer: B

Rationale: The correct answer is that the client is wearing a synthetic gown. A synthetic gown might generate sparks of static electricity, which can be a fire hazard, especially in the presence of oxygen. Clients on oxygen therapy should wear cotton gowns to minimize the risk of fire. The other options are not hazards for a client on oxygen therapy: having a 'No Smoking' sign on the door promotes safety by preventing smoking, ensuring electrical equipment is grounded reduces the risk of electrical hazards, and removing matches decreases the risk of fire hazards.

4. A Hispanic client brings her father to the clinic because he is becoming more forgetful. He is diagnosed with Alzheimer's disease. The woman tells the nurse that she wants to try ginkgo biloba for her father before using prescription medications. Which of the following is an appropriate response by the nurse?

• A. "It is wiser to start with a prescription."?
• B. "That herb may not be effective for your father."?
• C. "You can't expect an herb to cure Alzheimer's."?
• D. "I will let the physician know of your wishes."?

Correct answer: D

Rationale: The appropriate response is to acknowledge the client's wishes and communicate them to the physician for consideration. It is important to be culturally sensitive and respect the client's preferences. Ginkgo biloba has shown some benefits in treating dementia, so it is essential to involve the healthcare provider in the decision-making process. Choices A, B, and C are dismissive and fail to consider the client's perspective and cultural beliefs. It is crucial for healthcare professionals to engage in open communication and collaboration with clients to provide patient-centered care.

5. A 4-year-old client is unable to go to sleep at night in the hospital. Which nursing intervention best promotes sleep for the child?

• A. turning off the room light and closing the door
• B. engaging the child in calming activities before bedtime
• C. identifying the child's home bedtime rituals and following them
• D. encouraging relaxation techniques like deep breathing exercises

Correct answer: C

Rationale: For a 4-year-old client struggling to sleep in the hospital, the best nursing intervention is to identify the child's home bedtime rituals and follow them. Preschool-age children often have specific bedtime routines that provide comfort and promote sleep. This familiarity can help create a sense of security in an unfamiliar hospital environment. Choice A, turning off the room light and closing the door, may increase the child's fear of the dark and being alone. Choice B, engaging the child in calming activities before bedtime, is a better choice than tiring them with play exercises. Choice D, encouraging relaxation techniques like deep breathing exercises, although helpful, may not be as effective as following the child's familiar bedtime routines.

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