Nursing Elites

1. The client with congestive heart failure (CHF) is receiving discharge instructions. Which statement by the client indicates a need for further teaching?

• A. I will weigh myself daily and report a weight gain of more than 2 pounds in 24 hours.
• B. I will take my diuretic medication in the morning.
• C. I will call my healthcare provider if I experience increased shortness of breath.
• D. I will drink at least 3 liters of fluid each day.

Correct answer: D

Rationale: The correct answer is D. Drinking at least 3 liters of fluid each day may be contraindicated for a client with CHF due to the risk of fluid overload. This can exacerbate heart failure symptoms and lead to complications. Options A, B, and C are all appropriate statements that demonstrate understanding of managing CHF and seeking appropriate medical attention when needed.

2. When examining sources for funding, which criteria should the nurse clarify about the program for the community group?

• A. a prescription from the healthcare provider for each visit made
• B. documentation of a skilled care service provided during the visit
• C. a copy of the client's health history and social security card
• D. a record of the preventive healthcare services provided during the visit

Correct answer: C

Rationale: The correct answer is C because when seeking funding sources for a community outreach program, it is essential to clarify aspects related to the client's personal information, such as health history and identification details. This information helps in demonstrating the need for the program and understanding the target population. Choices A, B, and D are incorrect because they focus on clinical documentation, services provided during visits, and preventive healthcare services, which are not directly related to clarifying funding criteria about the program.

3. A public health nurse is working with a community to improve access to mental health services. Which intervention is most likely to be effective?

• A. Setting up mental health clinics in accessible locations
• B. Distributing flyers with information about mental health services
• C. Offering transportation vouchers for mental health appointments
• D. Partnering with local businesses to promote mental health

Correct answer: A

Rationale: The correct answer is A: Setting up mental health clinics in accessible locations. This intervention is the most effective as it directly addresses the issue of access to mental health services by physically bringing the services closer to the community members. Distributing flyers (choice B) may raise awareness but does not guarantee improved access. Offering transportation vouchers (choice C) helps with transportation but does not address the primary issue of service availability. Partnering with local businesses (choice D) may help promote mental health awareness but does not ensure improved access to services like setting up clinics in accessible locations.

4. A female client reports to the nurse that her sleep was interrupted by 'thoughts of anger towards my husband.' What type of thoughts is the client having?

• A. Obsessive.
• B. Phobic.
• C. Delusional.
• D. Paranoid.

Correct answer: A

Rationale: The correct answer is A: Obsessive. Obsessive thoughts are recurring, unwanted, and intrusive thoughts that cause distress or anxiety. In this scenario, the client is experiencing repetitive thoughts of anger towards her husband, indicating an inability to control these thoughts. Choice B, Phobic, is incorrect as phobic thoughts are related to irrational fears. Choice C, Delusional, is incorrect as delusional thoughts involve fixed false beliefs. Choice D, Paranoid, is incorrect as paranoid thoughts involve irrational suspicions and mistrust.

5. A client with a history of diabetes mellitus is admitted with diabetic ketoacidosis (DKA). Which finding requires immediate intervention?

• A. Blood glucose of 200 mg/dL.
• B. Serum bicarbonate of 20 mEq/L.
• C. Blood pressure of 140/90 mm Hg.
• D. Urine output of 50 mL in 4 hours.

Correct answer: D

Rationale: In a client with diabetic ketoacidosis (DKA), urine output of 50 mL in 4 hours indicates oliguria, which is a concerning sign of decreased renal perfusion and potential renal failure. This finding requires immediate intervention to prevent further deterioration of kidney function.\n\nChoice A (Blood glucose of 200 mg/dL) is elevated but not the most urgent concern in this scenario. Choice B (Serum bicarbonate of 20 mEq/L) reflects metabolic acidosis, which is expected in DKA but does not require immediate intervention. Choice C (Blood pressure of 140/90 mm Hg) is slightly elevated but not acutely concerning in the context of DKA.

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