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. A client was rushed in the E.R showing a whitish, leathery and painless burned area on his skin. The nurse is correct in classifying this burn as:

• A. First degree burn C. Third degree burn
• B. Second degree burn D. Partial thickness burn
• C.
• D.

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

3. Mrs. Seva also tells the nurse that she is often constipated. Because she is aging, what physical changes predispose her to constipation?

• A. inhibition of the parasympathetic reflex
• B. weakness of sphincter muscles of anus
• C. loss of tone of the smooth muscles of the colon
• D. decreased ability to absorb fluids in the lower intestines

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.

4. What chronic disease has been associated with increased risks of dental problems?

• A. diabetes mellitus
• B. chronic obstructive pulmonary disease
• C. Addison's disease
• D. asthma

Correct answer: A

Rationale: Diabetes mellitus is associated with an increased risk of dental problems, including gum disease and tooth loss, due to high blood sugar levels. While chronic obstructive pulmonary disease (COPD), Addison's disease, and asthma may have oral health implications, diabetes mellitus is specifically known for its strong association with dental issues.

5. What type of debridement involves proteolytic enzymes?

• A. Interventional C. Surgical
• B. Mechanical D. Chemical
• C.
• D.

Correct answer: B

Rationale: Nursing interventions should be grounded in a deep understanding of the physiological processes involved, ensuring that care provided is both effective and efficient.

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