what nursing diagnosis would be most appropriate for a patient with heart failure
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Nursing Elites

ATI RN

ATI Proctored Nutrition Exam

1. What nursing diagnosis would be most appropriate for a patient with heart failure?

Correct answer: B

Rationale: The most appropriate nursing diagnosis for a patient with heart failure is 'fluid volume excess.' In heart failure, the heart's reduced pumping ability leads to fluid retention, causing an excess of fluid in the body. This can result in symptoms such as edema, shortness of breath, and weight gain. 'Risk for infection,' 'impaired body temperature,' and 'ineffective airway clearance' are not the most appropriate nursing diagnoses for a patient with heart failure as they do not directly relate to the pathophysiology and common issues seen in heart failure patients.

2. Nurse Minette needs to schedule a first home visit to OB client Leah. When is a first home-care visit typically made?

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.

3. Mrs. Pichay who is for thoracentesis is assigned by the nurse to any of the following positions, EXCEPT:

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

4. Which food should the nurse recommend for a client deficient in vitamin A?

Correct answer: B

Rationale: The correct answer is B, steamed carrots, as they are high in vitamin A. Carrots are rich in beta-carotene, a precursor to vitamin A, which is essential for good vision, a healthy immune system, and cell growth. Oranges (choice A) are a good source of vitamin C but not vitamin A. Apple sauce (choice C) and baked potato (choice D) do not provide significant amounts of vitamin A compared to steamed carrots, making them less suitable recommendations for a client deficient in this specific nutrient.

5. A nurse is discussing denture care with the partner of a client who is unable to perform oral hygiene. Which of the following should be included in the discussion?

Correct answer: C

Rationale: The correct answer is C: 'Wrap gloved fingers with gauze to remove dentures.' This method provides a safe and effective way to remove dentures without causing damage. Choice A is incorrect because flossing dentures is not recommended. Choice B is incorrect as it suggests wiping dentures and storing them dry, which is not the best practice. Choice D is incorrect because using a washcloth may not effectively clean all denture surfaces.

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