Nursing Elites

1. In patients with heart failure, which type of diet is most recommended?

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

Correct answer: B

Rationale: In patients with heart failure, a low-sodium diet is most recommended. This type of diet helps manage fluid retention by reducing the amount of sodium in the body. Excess sodium can lead to fluid accumulation, putting additional strain on the heart. High-sodium diets can exacerbate symptoms of heart failure by causing fluid retention and increasing blood pressure. High-fat and low-carbohydrate diets are not specifically recommended for heart failure patients and may not address the underlying issues related to fluid balance and heart function.

2. The client diagnosed with acute vein thrombosis is receiving a continuous heparin drip, an intravenous anticoagulant. The health care provider orders warfarin (Coumadin), an oral anticoagulant. Which action should the nurse take?

• A. Discontinue the heparin drip prior to initiating the Coumadin
• B. Check the client’s INR prior to beginning Coumadin
• C. Clarify the order with the health care provider as soon as possible
• D. Administer the Coumadin along with the heparin drip as ordered

Correct answer: D

Rationale: The correct action for the nurse to take is to administer the Coumadin along with the heparin drip as ordered. Heparin and warfarin are often given together initially because warfarin takes a few days to become effective. Discontinuing the heparin drip prior to initiating Coumadin could leave the patient without anticoagulation coverage during the period when warfarin's effects are not yet established. Checking the client's INR prior to beginning Coumadin is important but not the immediate action to take when both medications are ordered together. Clarifying the order with the health care provider is unnecessary in this scenario as it is common practice to give heparin and warfarin concurrently in the transition period.

3. A client who is postpartum and has been diagnosed with iron deficiency anemia is receiving education from a nurse. Which dietary recommendation should be included in the education plan?

• A. Yogurt and mozzarella
• B. Spinach and beef
• C. Fish and cottage cheese
• D. Turkey slices and milk

Correct answer: B

Rationale: The correct answer is B: 'Spinach and beef.' Spinach and beef are high in iron, which is crucial for treating iron deficiency anemia. Spinach is a good source of non-heme iron, while beef provides heme iron, making them effective choices to increase iron levels in the body. Yogurt and mozzarella (Choice A), fish and cottage cheese (Choice C), and turkey slices and milk (Choice D) do not contain as high iron content as spinach and beef, making them less effective in addressing iron deficiency anemia.

4. Which hospital level is a 296-bed facility that is staffed and equipped to provide care for all categories of patients?

• A. FSB
• B. CSH
• C. GH
• D. FH

Correct answer: C

Rationale: The correct answer is "GH" (General Hospital), which is a 296-bed facility providing comprehensive care for all categories of patients. Choice A, FSB, is incorrect as it does not denote a hospital level. Choice B, CSH, is incorrect as it does not specify a 296-bed facility. Choice D, FH, is incorrect as it does not indicate a hospital level or capacity.

5. During peacetime, most CONUS hospital military personnel are organized into what type of organization?

• A. DVA
• B. TOE
• C. TDA
• D. NDMS

Correct answer: C

Rationale: During peacetime, most CONUS hospital military personnel are organized under a Table of Distribution and Allowances (TDA) structure. This organizational type outlines the personnel positions and equipment allocation within a unit. Choice A, 'DVA,' refers to the Department of Veterans Affairs and is not the organizational structure for military hospital personnel. Choice B, 'TOE,' stands for Table of Organization and Equipment which is more commonly used in a wartime setting to define unit structure and equipment requirements. Choice D, 'NDMS,' refers to the National Disaster Medical System which is not the typical organization for CONUS hospital military personnel during peacetime.

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