Nursing Elites

1. What is the best way to manage a patient's intake of dietary fiber?

• A. Increase intake gradually
• B. Increase intake suddenly
• C. Decrease intake abruptly
• D. Maintain a high intake

Correct answer: A

Rationale: The correct way to manage a patient's intake of dietary fiber is to increase it gradually. This approach helps prevent gastrointestinal discomfort that can occur when fiber intake is suddenly increased. Choice B is incorrect because sudden increases in fiber intake can lead to bloating, gas, and other digestive issues. Choice C is incorrect as decreasing fiber intake abruptly can disrupt bowel regularity and cause constipation. Choice D is incorrect because maintaining a high intake of fiber without considering the patient's current levels can also cause digestive problems.

2. The nurse on the postsurgical unit received a client who was transferred from the post-anesthesia care unit (PACU) and is planning care for this client. The nurse understands that staff should begin planning for this client’s discharge at which point during the hospitalization?

• A. Is admitted to the surgical unit
• B. Is transferred from the PACU to the postsurgical unit
• C. Is able to perform activities of daily living independently
• D. Has been assessed by the healthcare provider for the first time after surgery

Correct answer: A

Rationale: Discharge planning should begin as soon as the patient is admitted to the surgical unit to ensure a smooth transition. It is important to start early to address any potential barriers to discharge, coordinate resources, and provide adequate education and support. Choices B, C, and D are not the appropriate points to start discharge planning as they do not mark the beginning of the hospitalization phase related to the surgical unit.

3. The nurse is caring for a client on strict bed rest. Which intervention is the priority when caring for this client?

• A. Encourage the client to drink liquids
• B. Perform active range of motion exercises
• C. Elevate the head of the bed to 45 degrees
• D. Provide a high-fiber diet to the client

Correct answer: B

Rationale: Performing active range of motion exercises is the priority intervention for a client on strict bed rest. These exercises help prevent complications such as thromboembolism and muscle atrophy by promoting circulation and maintaining muscle strength. Encouraging liquids, elevating the head of the bed, and providing a high-fiber diet are important interventions but not the priority when compared to preventing serious complications associated with immobility.

4. Listed below are five categories that identify the responsibilities of the practical nurse manager in personnel management. Which of these categories is most appropriate for the task of 'Educate personnel on UCMJ'?

• A. Accountability
• B. Personal/professional development
• C. Individual training
• D. Military appearance/physical condition

Correct answer: B

Rationale: The correct answer is 'B: Personal/professional development.' Educating personnel on the Uniform Code of Military Justice (UCMJ) falls under the realm of personal/professional development, as it aims to enhance the knowledge and skills of individuals regarding military laws and regulations. Choice A, 'Accountability,' focuses more on responsibility and answerability rather than education. Choice C, 'Individual training,' is more specific to skill development and job-related learning rather than legal education. Choice D, 'Military appearance/physical condition,' pertains to maintaining physical standards and appearance, which is unrelated to educating personnel on UCMJ.

5. The nurse instructs a client 5 days after a lumbar laminectomy with spinal fusion about how to move from a supine position to standing at the left side of the bed with a walker. Which of the following directions by the nurse is BEST?

• A. Raise the head of the bed so you are sitting straight up, bend your knees, and swing your legs to the side and then to the floor
• B. Rock your body from side to side, going further each time until you build up enough momentum to be lying on your right side, and then raise your trunk toward your toes
• C. Reach over to the left side rail with your right hand, pull your body onto its side, bend your upper leg so the foot is on the bed, and push down to elevate your trunk
• D. Focus on using your arms, the left elbow as a pivot with the left hand grasping the mattress edge and the right hand pushing on the mattress above the elbow, then slide your legs over the side of the mattress

Correct answer: C

Rationale: The correct method described in option C helps maintain spinal alignment while moving from a lying to a standing position, which is crucial after a lumbar laminectomy with spinal fusion. This technique minimizes strain on the back and promotes safe movement. Choices A, B, and D involve movements that could potentially strain the back, increase the risk of injury, or compromise the spinal alignment, making them less optimal for the client recovering from such surgery.

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