Nursing Elites

1. For a patient with a history of liver disease, which type of diet is most appropriate?

• A. High-protein
• B. High-carbohydrate
• C. Low-protein
• D. Low-fat

Correct answer: D

Rationale: For a patient with a history of liver disease, a low-fat diet is most appropriate. Liver disease can impair fat metabolism, leading to fat accumulation in the liver cells and worsening the condition. A low-fat diet helps reduce stress on the liver and manage symptoms associated with liver disease. High-protein diets may not be suitable for individuals with liver disease as they can increase the risk of hepatic encephalopathy. High-carbohydrate diets may lead to insulin resistance and fat accumulation in the liver. While protein restriction may be necessary in some cases, a balanced intake of high-quality protein is essential for maintaining muscle mass and overall health, making a low-protein diet not the most appropriate choice for all patients with liver disease.

2. The nurse is told in report that the client has aortic stenosis. Which anatomical position should the nurse auscultate to assess the murmur?

• A. Second intercostal space, right sternal border
• B. Erb’s point
• C. Second intercostal space, left sternal border
• D. Fourth intercostal space, left sternal border

Correct answer: A

Rationale: The correct answer is A: Second intercostal space, right sternal border. The aortic valve is best auscultated at the second intercostal space, right sternal border, where the murmur of aortic stenosis is heard most clearly. Choices B, C, and D are incorrect as they are not the recommended anatomical positions for auscultating the murmur of aortic stenosis.

3. Are M6 practical nurses utilized in field units with patient holding capabilities?

• A. Yes
• B. No
• C. -
• D. -

Correct answer: A

Rationale: Yes, M6 practical nurses are utilized in field units with patient holding capabilities. These nurses play a crucial role in providing care and support in various healthcare settings. Given this context, the correct answer is 'Yes.' Choice B, 'No,' is incorrect because M6 practical nurses can indeed work in field units with patient holding capabilities, as stated in the extract. Choices C and D are not applicable in this question.

4. Which outcome should the nurse identify for the client diagnosed with fluid volume excess?

• A. The client will void a minimum of 30 mL per hour
• B. The client will have elastic skin turgor
• C. The client will have no adventitious breath sounds
• D. The client will have a serum creatinine of 1.4 mg/dL

Correct answer: C

Rationale: The correct answer is C. Absence of adventitious breath sounds indicates that fluid is not accumulating in the lungs, a key outcome in managing fluid volume excess. Choices A, B, and D are incorrect. A client with fluid volume excess may not necessarily void a minimum of 30 mL per hour, have elastic skin turgor, or have a specific serum creatinine level. The absence of adventitious breath sounds is a more direct indicator of managing fluid volume excess.

5. The client diagnosed with acute pancreatitis has developed a pseudocyst that ruptures. Which procedure should the nurse anticipate the HCP ordering?

• A. Paracentesis
• B. Chest tube insertion
• C. Lumbar puncture
• D. Biopsy of the pancreas

Correct answer: B

Rationale: The correct answer is B: Chest tube insertion. In the context of a pancreatic pseudocyst rupturing, a chest tube may be needed if the pseudocyst extends into the pleural space, leading to a pleural effusion. Choice A, paracentesis, involves the removal of fluid from the abdominal cavity, not the pleural space. Choice C, lumbar puncture, is a procedure performed to collect cerebrospinal fluid from the spinal canal, not relevant in this scenario. Choice D, biopsy of the pancreas, is not indicated in the immediate management of a ruptured pseudocyst.

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