Nursing Elites

1. As the head nurse in the OR, how can you improve the effectiveness of clinical alarm systems?

• A. Limit suppliers to a few so that quality is maintained
• B. Implement a regular inventory of supplies and equipment
• C. Adherence to manufacturer’s recommendation
• D. Implement a regular maintenance and testing of alarm systems

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

2. Mang David, A 27 year old psychiatric client was admitted with a diagnosis of schizophrenia. During the morning assessment, Mang David shouted “Did you know that I am the top salesman in the world? Different companies want me!” As a nurse, you know that this is an example of:

• A. Hallucination
• B. Delusion
• C. Confabulation
• D. Flight of Ideas

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

3. A nurse is planning care for a client who has ascites secondary to liver disease. Which of the following interventions should the nurse include in the plan of care?

• A. Reduce complex carbohydrates to 30% of total calories.
• B. Restrict protein intake to less than 0.8 g/kg/day.
• C. Decrease daily caloric intake by 20%.
• D. Limit sodium to 2000 mg or less per day.

Correct answer: D

Rationale: The correct answer is to limit sodium to 2000 mg or less per day. Ascites, which is the abnormal accumulation of fluid in the abdominal cavity, is commonly associated with liver disease. Limiting sodium intake helps manage fluid retention by reducing the fluid accumulation in the abdomen. Choices A, B, and C are incorrect because reducing complex carbohydrates, restricting protein intake, or decreasing caloric intake are not the primary interventions for managing ascites in liver disease.

4. A client is being taught about foods to include in a low-fiber diet. Which statement indicates the client understands the teaching?

• A. "A fresh pear would be a good snack option."?
• B. "I can prepare refried beans for supper."?
• C. "Bran cereal would be a good breakfast choice."?
• D. "I should choose white rice as a side dish."?

Correct answer: D

Rationale: The correct answer is "I should choose white rice as a side dish." In a low-fiber diet, foods that are low in fiber are recommended to reduce gastrointestinal irritation. White rice is a low-fiber option suitable for this diet. Choices A, B, and C are high-fiber options and not suitable for a low-fiber diet. A fresh pear, refried beans, and bran cereal are all high in fiber, which should be avoided in a low-fiber diet.

5. In any event of an adverse hemolytic reaction during blood transfusion, Nursing intervention should focus on:

• A. Slow the infusion, Call the physician and assess the patient
• B. Stop the infusion, Assess the client, Send the remaining blood to the laboratory and call the physician
• C. Stop the infusion, Call the physician and assess the client
• D. Slow the confusion and keep a patent IV line open for administration of medication

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

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