Nursing Elites

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

• A. risk for infection
• B. fluid volume excess
• C. impaired body temperature
• D. ineffective airway clearance

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. Is the statement 'The metabolic rate is the highest after a few hours of sleep' true or false?

• A. True
• B. False
• C.
• D.

Correct answer: B

Rationale: The statement is false. The metabolic rate is actually lowest during sleep and increases upon waking. During sleep, the body conserves energy, leading to a lower metabolic rate. As the body wakes up and becomes active, the metabolic rate increases to support the body's functions and energy needs. Therefore, the metabolic rate is not the highest after a few hours of sleep, making the statement false.

3. Each is a characteristic manifestation of necrotizing ulcerative gingivitis (NUG), except one. Which is the exception?

• A. Gingival erythema
• B. Necrosis of interdental papilla
• C. Marasmus
• D. Metallic taste and foul odor

Correct answer: C

Rationale: The correct answer is C: Marasmus. Marasmus is a form of severe malnutrition and is not a direct manifestation of necrotizing ulcerative gingivitis (NUG). Choices A, B, and D are all characteristic manifestations of NUG. Gingival erythema, necrosis of interdental papilla, and metallic taste with foul odor are commonly associated with NUG due to the inflammatory and necrotic nature of the condition.

4. A client is prescribed a 1500-calorie diet. Thirty percent of the calories are to be derived from fat. How many grams of fat should the nurse tell the client to consume per day? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

• A. 21
• B. 49
• C. 60
• D. 50

Correct answer: D

Rationale: To calculate the grams of fat, first, determine the calories from fat by multiplying the total calorie intake (1500 calories) by the percentage of calories from fat (30%), which equals 450 calories from fat. Since 1 gram of fat is equivalent to 9 calories, divide the total calories from fat (450) by the calories in 1 gram of fat (9) to get the answer in grams, which is 50. Therefore, the client should consume 50 grams of fat per day. Choice A (21), Choice B (49), and Choice C (60) are incorrect as they do not reflect the accurate calculation based on the given information.

5. A nurse is providing dietary teaching for a client who has just learned that she has type 2 diabetes mellitus. The nurse should explain that which of the following sweeteners will add calories to the client's carbohydrate count?

• A. Sorbitol
• B. Sucralose
• C. Aspartame
• D. Acesulfame potassium

Correct answer: A

Rationale: Sorbitol is a sweetener that will add calories to the client's carbohydrate count. It is a sugar alcohol that provides about 2.6 calories per gram. Sucralose, aspartame, and acesulfame potassium are all non-nutritive sweeteners that do not contribute significant calories to the diet. Sucralose is about 600 times sweeter than sucrose but does not add calories. Aspartame is a low-calorie sweetener that is approximately 200 times sweeter than sucrose, and acesulfame potassium is a calorie-free sweetener.

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