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. Signs of internal bleeding include all of the following except:

• A. painful or swollen extremities
• B. a tender, rigid abdomen
• C. vomiting bile
• D. bruising

Correct answer: C

Rationale: Vomiting bile is not typically a sign of internal bleeding but is more commonly associated with issues in the gastrointestinal tract. Signs of internal bleeding include painful or swollen extremities, a tender, rigid abdomen, and bruising. Painful or swollen extremities can indicate bleeding from an extremity injury, a tender, rigid abdomen can signal abdominal bleeding, and bruising can result from blood vessel damage. Therefore, the correct answer is 'C: vomiting bile,' as it is not a typical sign of internal bleeding.

3. The nurse is caring for a client awaiting test results on a biopsy. The client is unconscious, and the physician informs the client's spouse that the biopsy came back positive for cancer. The spouse asks the nurse if they will not share this news with the client because they would prefer the client be unaware of the diagnosis. Which of the following responses is most appropriate?

• A. "I will have a psychiatrist confirm whether the news will cause negative effects, and if so, I will comply with your request."?
• B. "For ethical reasons, I am unable to withhold this information from the client."?
• C. "You do not have the option to sign paperwork stating you are accepting the risk of not sharing this with the client."?
• D. "You must have a durable power of attorney for healthcare advanced directive in place before I can consider this request."?

Correct answer: B

Rationale: The correct response is, "For ethical reasons, I am unable to withhold this information from the client."? The ethical principle of veracity requires that the nurse is truthful with the client and does not withhold information even if it is requested by the family. Choice A is incorrect because seeking a psychiatrist's confirmation is not necessary to uphold the ethical principle of truth-telling. Choice C is incorrect as implying that signing paperwork overrides the nurse's ethical obligation to be honest with the client is inappropriate. Choice D is also incorrect as a durable power of attorney is not relevant in this situation where the spouse is asking the nurse to withhold information.

4. A gastroenterologist should be consulted for clients suffering from:

• A. digestive system diseases
• B. urinary system diseases
• C. female reproductive system diseases
• D. nervous system diseases

Correct answer: A

Rationale: A gastroenterologist specializes in treating diseases and disorders of the digestive system, including the stomach, intestines, liver, and pancreas. Therefore, clients with digestive system diseases should consult a gastroenterologist. Choices B, C, and D are incorrect because urinary system diseases are managed by urologists, female reproductive system diseases by gynecologists, and nervous system diseases by neurologists.

5. The nurse should teach parents of small children that the most common type of first-degree burn is:

• A. scalding from hot bath water or spills
• B. contact with hot surfaces such as stoves and fireplaces
• C. contact with flammable liquids or gases resulting in flash burns
• D. sunburn from lack of protection and overexposure

Correct answer: D

Rationale: The most common type of first-degree burn in small children is sunburn, often due to lack of protection and overexposure to the sun. This type of burn highlights the importance of educating parents about using sunscreens and ensuring children are adequately protected from the sun's harmful rays. Choices A, B, and C describe scenarios that can lead to burns but are not the most common type of first-degree burn in small children, making them incorrect.

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