Nursing Elites

1. 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.

2. What is a major constituent of cell membranes?

• A. cholesterol
• B. phospholipid
• C. saturated
• D. triglyceride

Correct answer: B

Rationale: Phospholipids are a major component of cell membranes, providing structural integrity and facilitating cell signaling. Cholesterol (choice A) is also present in cell membranes but in smaller amounts and plays a different role. Saturated (choice C) and triglyceride (choice D) are not major constituents of cell membranes.

3. A client is being taught how to follow a low-purine diet for gout management. Which statement indicates the client understands the teaching?

• A. "I will need to limit the number of fruit servings each day."?
• B. "I should avoid eating liver and other organ meats."?
• C. "I can drink only white wine."?
• D. "I should choose red meat instead of poultry."?

Correct answer: B

Rationale: The correct answer is B. Organ meats like liver are high in purines, which can exacerbate gout symptoms. Choosing to avoid such foods is essential in following a low-purine diet. Option A is incorrect because fruits are generally low in purines and are not usually restricted in a low-purine diet. Option C is incorrect as white wine, just like other types of alcohol, should be consumed in moderation or avoided due to its purine content. Option D is incorrect because red meat, including beef and lamb, is high in purines and should be limited in a low-purine diet.

4. Which metabolic disease is characterized by poor healing, severe forms of periodontal disease, necrosis, xerostomia, and candidiasis?

• A. Hypopituitarism
• B. Diabetes mellitus
• C. Hyperthyroidism
• D. Renal disease

Correct answer: B

Rationale: Diabetes mellitus is the correct answer. It is associated with poor wound healing, severe periodontal disease, tissue necrosis, dry mouth (xerostomia), and an increased susceptibility to oral infections like candidiasis. Hypopituitarism, hyperthyroidism, and renal disease are not typically linked to the specific oral manifestations described in the question.

5. As a nurse, you can help improve the effectiveness of communication among healthcare givers by:

• A. Use of reminders of ‘what to do’
• B. Using standardized list of abbreviations, acronyms, and symbols
• C. One-on-one oral endorsement
• D. Text messaging and e-mail

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.

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