Nursing Elites

1. What is the name of a legal document that instructs health care providers and family members about what life-sustaining treatment an individual wants if they are unable to make decisions?

• A. Do Not Resuscitate
• B. Informed consent
• C. Living will
• D. Durable power of attorney for health care

Correct answer: C

Rationale: The correct answer is C, 'Living will.' A living will is a legal document that outlines an individual's preferences for life-sustaining medical treatment if they become unable to make decisions. Choice A, 'Do Not Resuscitate,' specifically refers to a directive that instructs healthcare providers not to perform CPR. Choice B, 'Informed consent,' pertains to a patient's right to be informed about and consent to medical treatment. Choice D, 'Durable power of attorney for health care,' involves appointing someone to make healthcare decisions on behalf of an individual when they are unable to do so.

2. A nurse is in an acute care facility, caring for a client who is postop following abdominal surgery. Which behavior should the nurse identify as increasing the client's risk for constipation?

• A. Increased fiber intake
• B. Suppression of the urge to defecate
• C. Ambulation twice a day
• D. Daily laxative use

Correct answer: B

Rationale: The correct answer is B: 'Suppression of the urge to defecate.' Suppressing the urge to defecate can lead to constipation, especially in postoperative clients. It is essential to encourage clients to respond to the urge to defecate to prevent constipation. Increased fiber intake (Choice A) is beneficial for preventing constipation. Ambulation (Choice C) helps promote bowel motility and can reduce the risk of constipation. Daily laxative use (Choice D) may contribute to laxative dependence but is not the behavior most directly associated with increasing the risk of constipation in this scenario.

3. A nurse is assessing a client with a history of heart failure. Which of the following findings should the nurse monitor?

• A. Increased energy
• B. Peripheral edema
• C. Elevated heart rate
• D. Improved lung sounds

Correct answer: B

Rationale: The correct answer is B: Peripheral edema. In heart failure, the heart's inability to pump effectively can lead to fluid backup, causing swelling in the extremities, known as peripheral edema. Monitoring for peripheral edema is crucial as it is a common sign of worsening heart failure. Choices A, C, and D are incorrect because increased energy, elevated heart rate, and improved lung sounds are not typical findings in heart failure. Increased energy is not usually associated with heart failure, an elevated heart rate may occur as a compensatory mechanism but is not a direct sign of heart failure, and improved lung sounds are not expected in heart failure which often presents with crackles or wheezes due to pulmonary congestion.

4. A nurse is preparing to administer furosemide 4 mg/kg/day PO divided into 2 equal doses daily to a toddler who weighs 22 lb. How many mg should the nurse administer per dose?

• A. 10 mg
• B. 20 mg
• C. 30 mg
• D. 40 mg

Correct answer: B

Rationale: To calculate the correct dose, first, convert the toddler's weight from pounds to kilograms: 22 lb / 2.2 lb/kg = 10 kg. Next, multiply the weight in kilograms by the dosage: 4 mg/kg x 10 kg = 40 mg/day. Since the total daily dose is divided into 2 equal doses, each dose would be 20 mg. Therefore, the correct answer is 20 mg. Choice A (10 mg) is incorrect because it does not account for the correct weight-based dosage. Choice C (30 mg) and Choice D (40 mg) are incorrect as they do not correctly calculate the dose based on the weight of the toddler and the prescribed dosage per kg.

5. A nurse is assisting with meal planning for a client who has been prescribed a mechanical soft diet. The nurse should instruct the client to avoid which of the following foods?

• A. Applesauce
• B. Mashed potatoes
• C. Orange slices
• D. Soft bread

Correct answer: C

Rationale: The correct answer is C: Orange slices. Orange slices contain membranes that are difficult to swallow, which can pose a risk to clients on a mechanical soft diet. This type of diet is designed for individuals who have difficulty chewing or swallowing. Choices A, B, and D are suitable for a mechanical soft diet as they are soft in texture and easy to chew and swallow.

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