Nursing Elites

1. In an extreme situation and when no other resident or intern is available, should a nurse receive telephone orders, the order has to be correctly written and signed by the physician within:

• A. 24 hours
• B. 36 hours
• C. 48 hours
• D. 12 hours

Correct answer: B

Rationale: In an extreme situation where no other resident or intern is available, if a nurse receives telephone orders, the order has to be correctly written and signed by the physician within 36 hours. This time frame ensures timely documentation and validation of the orders. Choice A (24 hours) is too short a period for busy physicians to fulfill the task. Choice C (48 hours) is too long and delays the incorporation of physician orders into the patient's care plan. Choice D (12 hours) may not provide enough time for the physician to review and sign the order, especially in situations where immediate attention is not required.

2. 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.

3. A client with cholecystitis is being taught about required dietary modifications. Which of the following foods is appropriate for the client's diet?

• A. Creamed chicken
• B. Roast turkey
• C. Ice cream
• D. Macaroni and cheese

Correct answer: B

Rationale: Roast turkey is the most appropriate choice for a client with cholecystitis. Foods that are high in fat content, like creamed chicken, ice cream, and macaroni and cheese, should be avoided in cholecystitis as they can exacerbate symptoms due to the reduced ability of the gallbladder to process fats. Roast turkey is a leaner option that is better tolerated by individuals with cholecystitis.

4. A fire has broken in the unit of DMLM R.N. The best leadership style suited in cases of emergencies like this is:

• A. Autocratic
• B. Participative
• C. Democratic
• D. Laissez Faire

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

5. James wants to know the recommended intake for iron for his gender and age. Which of the following would provide the best answer for James?

• A. EAR
• B. UL
• C. RDA
• D. DV

Correct answer: C

Rationale: The Recommended Dietary Allowance (RDA) is the correct answer for James because it provides the daily intake level that meets the nutrient needs of most healthy individuals in a specific age and gender group. Choice A, EAR (Estimated Average Requirement), represents the average daily nutrient intake level estimated to meet the requirement of half the healthy individuals in a particular life stage and gender group. Choice B, UL (Tolerable Upper Intake Level), is the maximum daily intake unlikely to cause adverse health effects. Choice D, DV (Daily Value), is a general guide used for food labeling that represents how much a nutrient in a serving of food contributes to a daily diet based on a 2000-calorie daily intake.

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