Nursing Elites

1. What dietary alterations should a pregnant client with congenital heart disease expect?

• A. reduced calories and reduced fat
• B. caffeine and sodium restrictions
• C. decreased protein and increased complex carbohydrates
• D. fluid restriction and reduced calories

Correct answer: B

Rationale: In a pregnant client with congenital heart disease, caffeine should be restricted as it can increase heart rate, which is already under stress due to pregnancy. Sodium restrictions may be necessary to prevent fluid retention, which can worsen the client's heart condition. Decreasing calories, fat, protein, or fluid may not be appropriate as these can lead to nutrient deficiencies or inadequate energy intake, which is crucial during pregnancy. Therefore, options A, C, and D are not the expected dietary alterations in the client's diet during pregnancy with congenital heart disease.

2. A case manager is serving on a community task force on violence in schools. The members of the task force are planning to develop interventions to help prevent violence. According to the nursing process, which is the first activity that the case manager would suggest to the task force?

• A. Teaching schoolchildren about the dangers of school violence
• B. Conducting a community survey to assess community perceptions regarding school violence
• C. Looking at what other communities are doing about school violence
• D. Distributing flyers that identify the causes of school violence to families in the community

Correct answer: B

Rationale: The correct answer is to conduct a community survey to assess community perceptions regarding school violence. In the nursing process, assessment is always the first step. By conducting a survey, the task force can gather important data about how the community perceives school violence, which is essential for developing effective interventions. Choices A, C, and D involve actions that come after the assessment phase. Teaching schoolchildren about the dangers of violence and distributing flyers are important activities but should come after understanding the community's perceptions and needs. Looking at what other communities are doing is valuable but should also follow a thorough assessment of the specific community's needs and perceptions.

3. The laws enacted by states to provide immunity from liability to persons who provide emergency care at an accident scene are called:

• A. Good Samaritan laws.
• B. HIPAA.
• C. Patient Self-Determination Act (PSDA).
• D. OBRA.

Correct answer: A

Rationale: The correct answer is Good Samaritan laws. These laws protect individuals who provide voluntary emergency care from being held liable for any unintended injury or harm that may occur during the care. Good Samaritan laws encourage individuals to assist in emergencies without fear of legal repercussions. HIPAA, on the other hand, focuses on safeguarding patient information and privacy, ensuring confidentiality. The Patient Self-Determination Act (PSDA) pertains to a patient's rights to make decisions about their medical treatment and advance directives. OBRA, enacted in the late 1980s, aims to improve the quality of care in nursing homes and enhance residents' quality of life, focusing on nursing home reform and standards, which is not directly related to immunity for emergency care providers.

4. What should a client room environment include?

• A. a made bed, fresh water, thermostat regulation, and clean floors in all occupied client areas.
• B. a made bed, comfort and safety, a clutter-free area, hygiene articles nearby.
• C. accident prevention, comfort, a room (including furniture) that has been cleaned with chloroseptic wash, a bed that is made every other day.
• D. odor control (by spraying the room with deodorizers), closet storage of all client objects, a clean room. (Gloves should be worn when cleaning.)

Correct answer: B

Rationale: A client room environment should include a made bed to provide a sense of neatness and comfort, ensuring the client's safety at all times. It is important to maintain a clutter-free area to prevent accidents and promote a relaxing environment. Having hygiene articles nearby allows the client easy access to personal care items. Choice A is incorrect because while fresh water and thermostat regulation are important, they are not essential components of a client room environment. Choice C is incorrect as it emphasizes more on cleaning procedures rather than creating a comfortable and safe environment for the client. Choice D is incorrect as it emphasizes odor control and storage rather than the client's comfort and safety.

5. A client asks a nurse about the procedure for becoming an organ donor. The nurse provides the client with which information?

• A. To speak with the chaplain about the psychosocial aspects of becoming a donor
• B. That this decision must be made by the next of kin at the time of the client's death
• C. That anatomic gifts must be made in writing and signed by the client
• D. To let the health care provider know about the request so that it may be documented in the client's record

Correct answer: C

Rationale: When a person wishes to become an organ donor, they need to understand that anatomic gifts must be made in writing and signed by the individual. The gift must be made by the donor themselves, typically an individual who is at least 18 years old. If the client is unable to sign, the document should be signed by another person and two witnesses. While speaking to a chaplain or informing the healthcare provider may be part of the process, the essential step is to have a written document signed by the client. Choice A is incorrect as it does not address the procedural aspect of becoming an organ donor. Choice B is incorrect as the decision to make an anatomic gift is typically made by the individual themselves, not the next of kin. Choice D is incorrect as simply informing the healthcare provider is not sufficient for the procedure of becoming an organ donor; a written and signed document by the client is necessary.

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