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. All of the following are instructions for proper foot care to be given to a client with peripheral vascular disease caused by diabetes. Which one is not?

• A. Trim nails using a nail clipper
• B. Apply cornstarch to the foot
• C. Always check the temperature of the water before bathing
• D. Use canvas shoes

Correct answer: A

Rationale: The correct answer is 'A', which says trim nails using a nail clipper. This is incorrect because patients with peripheral vascular disease, particularly those caused by diabetes, should not trim their nails themselves due to the risk of injury, infection, and poor wound healing. The other options, 'B', 'C', and 'D', are correct advice for diabetic foot care. Applying cornstarch can help keep the feet dry and prevent fungal infections. Checking the water temperature before bathing can prevent burns, as patients with peripheral vascular disease often have decreased sensation in their feet. Wearing canvas shoes can improve foot ventilation and reduce the risk of foot ulcers and infections.

3. Which mental health disorder can lead to the erosion of lingual enamel, enlarged parotid glands, palatal bruising, and dentinal hypersensitivity?

• A. Bulimia
• B. Anorexia nervosa
• C. Depression
• D. Schizophrenia

Correct answer: A

Rationale: The correct answer is A: Bulimia. Bulimia involves repeated episodes of binge eating followed by purging, which can lead to the erosion of lingual enamel, enlarged parotid glands, palatal bruising, and dentinal hypersensitivity. This behavior exposes the teeth to stomach acid during purging, causing damage to the enamel. Choices B, C, and D are incorrect because these conditions are not typically associated with the specific oral health issues mentioned in the question.

4. Which of the following categories identifies the focus of community/public health nursing practice?

• A. Promoting and maintaining the health of populations and preventing and minimizing the progress of disease
• B. Rehabilitation and restorative services
• C. Adaptation of hospital care to the home environment
• D. Hospice care delivery

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.

5. When a nurse signs a consent form, which ethical principle is being observed regarding the patient?

• A. Autonomy
• B. Justice
• C. Accountability
• D. Beneficence

Correct answer: A

Rationale: The correct answer is 'Autonomy'. Autonomy refers to the patient's right to make their own decisions, which is being honored when a nurse signs a consent form. While beneficence (Choice D) is an important ethical principle that involves acting in the patient's best interest, it is not what is being primarily observed in this instance. Justice (Choice B) refers to fairness and equal treatment and is not specifically relevant to this scenario. Accountability (Choice C) pertains to being answerable for one's actions and decisions, but again, it is not the principle directly observed in this situation. Therefore, when a nurse signs a consent form, it is the principle of autonomy that is being observed.

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