Nursing Elites

1. In the management of heart failure, which diuretic is preferred due to its demonstrated significant mortality reduction in patients with heart failure?

• A. Furosemide (Lasix)
• B. Hydrochlorothiazide (HydroDIURIL)
• C. Spironolactone (Aldactone)
• D. Mannitol (Osmitrol)

Correct answer: C

Rationale: Spironolactone, a potassium-sparing diuretic, is the preferred choice in heart failure due to its cardio-protective effect, leading to reduced mortality in patients with heart failure. It is used to manage both hypertension and edema, making it a valuable option in heart failure treatment.

2. When teaching a parent of a 2-month-old infant with acute gastroenteritis who is bottle feeding, which of the following statements should the nurse include?

• A. Offer Pedialyte between formula feedings.
• B. Feed the infant every 6 hours.
• C. Give diluted apple juice if the infant becomes dehydrated.
• D. Switch to soy-based formula permanently.

Correct answer: A

Rationale: In the case of acute gastroenteritis in a 2-month-old infant who is bottle feeding, the nurse should recommend offering Pedialyte between formula feedings. This helps prevent dehydration and ensures that the infant receives essential electrolytes and fluids to aid in recovery. Pedialyte is specifically formulated to help replace lost fluids and electrolytes due to vomiting and diarrhea, making it a suitable choice for infants with gastroenteritis. Choice B is incorrect because infants with acute gastroenteritis should be fed more frequently to prevent dehydration. Choice C is incorrect as apple juice is not recommended for infants with gastroenteritis; Pedialyte or oral rehydration solutions are preferred. Choice D is incorrect because switching to soy-based formula permanently is not necessary for managing acute gastroenteritis; Pedialyte and continuing with the current formula are more appropriate.

3. A client has a new diagnosis of celiac disease. Which of the following clinical manifestations should the nurse expect?

• A. Steatorrhea
• B. Projectile vomiting
• C. Sunken abdomen
• D. Weight gain

Correct answer: A

Rationale: Celiac disease is a condition where individuals are unable to digest gluten, leading to damage in the bowel cells and subsequent malabsorption. This malabsorption commonly presents with symptoms such as steatorrhea, which is characterized by foul-smelling, greasy, and bulky stools due to high fat content. Projectile vomiting and sunken abdomen are not typical manifestations of celiac disease. Weight gain is unlikely in individuals with celiac disease due to malabsorption and nutrient deficiencies. Therefore, the nurse should expect steatorrhea as a clinical manifestation in clients with celiac disease.

4. A parent of a school-age child is receiving discharge teaching following a cardiac catheterization. Which of the following instructions should be included by the nurse?

• A. Allow the child to bathe 6 hours after the procedure.
• B. Keep the child on bed rest for 12 hours.
• C. Maintain a pressure dressing on the site for 8 hours.
• D. Resume regular activities the day after the procedure.

Correct answer: B

Rationale: The correct instruction that the nurse should include is to keep the child on bed rest for 12 hours following a cardiac catheterization. This is important to prevent bleeding at the insertion site and ensure proper healing. Allowing the child to bathe soon after the procedure, maintaining a pressure dressing for only 8 hours, or resuming regular activities the day after the procedure can increase the risk of complications such as bleeding or infection.

5. Which statement is not part of the developmental care approach?

• A. Family-centered care
• B. Care on a sliding payment scale
• C. Healing environment
• D. Protected sleep

Correct answer: B

Rationale: The developmental care approach emphasizes creating an environment that supports the infant's developmental needs, including family-centered care, a healing environment, and promoting protected sleep. Payment scale considerations are not a component of developmental care.

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