Nursing Elites

1. The healthcare professional is assessing a client with a history of rheumatoid arthritis. Which of the following assessment findings would be most concerning?

• A. Morning stiffness
• B. Joint deformities
• C. Fever
• D. Weight loss

Correct answer: C

Rationale: In a client with rheumatoid arthritis, the presence of fever is most concerning because it may indicate an infection or systemic involvement, necessitating immediate attention. Morning stiffness and joint deformities are common manifestations of rheumatoid arthritis itself and are expected findings in these clients. Weight loss can occur in rheumatoid arthritis due to various factors such as decreased appetite or systemic inflammation, but it is not as acutely concerning as fever, which may signal a more urgent issue.

2. What is the most suitable snack food for the LPN/LVN to offer a client with myasthenia gravis who is at risk for altered nutritional status?

• A. Chocolate pudding.
• B. Graham crackers.
• C. Sugar-free gelatin.
• D. Apple slices.

Correct answer: A

Rationale: Chocolate pudding is the best snack food choice for a client with myasthenia gravis at risk for altered nutritional status due to its nutrient density and soft texture, which can be easier for clients with swallowing difficulties to consume. Graham crackers, sugar-free gelatin, and apple slices may not provide the same level of nutrient density or ease of consumption for these clients. Graham crackers and apple slices may also pose challenges for clients with swallowing difficulties, while sugar-free gelatin, although a good option for some clients, may not offer the same level of nutrition as chocolate pudding.

3. A dying client is coping with feelings regarding impending death. The nurse bases care on the theory of death and dying by Kübler-Ross. During which stage of grieving should the LPN/LVN primarily use nonverbal interventions?

• A. Anger
• B. Denial
• C. Bargaining
• D. Acceptance

Correct answer: D

Rationale: Nonverbal interventions are primarily used during the acceptance stage according to Kübler-Ross's theory of death and dying. During the acceptance stage, the individual is more likely to be reflective and less communicative, making nonverbal interventions more effective. Choices A, B, and C are incorrect because anger, denial, and bargaining are stages that precede the acceptance stage in Kübler-Ross's model, where verbal communication and processing emotions play a more significant role.

4. The UAPs working on a chronic neuro unit ask the LPN/LVN to help them determine the safest way to transfer an elderly client with left-sided weakness from the bed to the chair. What method describes the correct transfer procedure for this client?

• A. Place the chair at a right angle to the bed on the client's left side before moving.
• B. Assist the client to a standing position, then place the right hand on the armrest.
• C. Have the client place the left foot next to the chair and pivot to the left before sitting.
• D. Move the chair parallel to the right side of the bed, and stand the client on the right foot.

Correct answer: D

Rationale: The correct method for transferring an elderly client with left-sided weakness from the bed to the chair involves moving the chair parallel to the right side of the bed and standing the client on the right foot. This technique provides a stable and safe transfer by utilizing the stronger side of the client to support the transfer. Choices A, B, and C are incorrect because placing the chair at a right angle to the bed on the client's left side, assisting the client to a standing position and placing the right hand on the armrest, and having the client pivot to the left before sitting do not address the client's left-sided weakness and may increase the risk of falls or injuries.

5. A 25-year-old primigravida at 16 weeks gestation is admitted to the hospital with a diagnosis of hyperemesis gravidarum. Which nursing diagnosis should have the highest priority?

• A. Fluid volume deficit
• B. Altered nutrition: less than body requirements
• C. Anxiety related to new situational crisis
• D. Activity intolerance related to fatigue

Correct answer: A

Rationale: In a case of hyperemesis gravidarum, the priority nursing diagnosis should be addressing the Fluid volume deficit. This condition can lead to serious complications such as electrolyte imbalances and dehydration, which can endanger both the mother and the fetus if not managed promptly. Altered nutrition: less than body requirements is important but addressing the fluid volume deficit takes precedence as it poses an immediate threat. Anxiety related to new situational crisis and Activity intolerance related to fatigue are valid concerns, but they are secondary to the critical issue of fluid volume deficit in this scenario.

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