Nursing Elites

1. The nurse is caring for a client with hyperemesis gravidarum. What is the most likely electrolyte imbalance?

• A. Hypocalcemia
• B. Hypomagnesemia
• C. Hyponatremia
• D. Hypokalemia

Correct answer: D

Rationale: In hyperemesis gravidarum, where the client experiences severe nausea and vomiting, the most likely electrolyte imbalance is hypokalemia. Potassium is abundant in the stomach, and excessive vomiting leads to potassium loss. Hypocalcemia (Choice A) is not typically associated with hyperemesis gravidarum. Hypomagnesemia (Choice B) and Hyponatremia (Choice C) are less likely to occur compared to hypokalemia in this condition.

2. Support systems during the grieving process include all of the following except:

• A. a despondent friend.
• B. a nurse.
• C. a social worker.
• D. a family member.

Correct answer: B

Rationale: During the grieving process, it is essential to have a support system in place. Options B, C, and D - a nurse, a social worker, and a family member, respectively, are individuals who can provide comfort, guidance, and practical assistance to someone who is grieving. However, a despondent friend, as stated in the question, is not an ideal choice for support during this period. A despondent friend is someone who is feeling extremely unhappy and discouraged, and may not have the emotional capacity to provide the needed support to a grieving individual. It is important for someone who is grieving to have support from individuals who can offer understanding, empathy, and strength, which a despondent friend may struggle to provide.

3. The healthcare provider should utilize data about which of the following to provide information about the nutritional status of a client being evaluated for malnutrition?

• A. triceps skinfold measurement
• B. fasting blood glucose level
• C. hemoglobin A1c level
• D. serum lipid profile results

Correct answer: A

Rationale: Objective anthropometric measurements such as triceps skinfold and mid-arm circumference (MAC), along with weight, are usually used to diagnose malnutrition. Triceps skinfold measurement specifically helps assess body fat and muscle mass, providing valuable information about the client's nutritional status. Fasting blood glucose level, hemoglobin A1c level, and serum lipid profile results are important tests in assessing different aspects of health such as diabetes management and cardiovascular risk, but they are not specific indicators of malnutrition.

4. Which of the following classifications of medications is used to help decrease tremors for clients with hyperthyroidism?

• A. Steroids
• B. Anticonvulsants
• C. Beta blockers
• D. Iodine compounds

Correct answer: C

Rationale: The correct answer is Beta blockers. Beta blockers are commonly used to help decrease tremors in clients with hyperthyroidism by blocking the action of adrenaline. This helps to control symptoms such as rapid heart rate, tremors, and anxiety. Steroids (Choice A) are not typically used to treat tremors in hyperthyroidism. Anticonvulsants (Choice B) are primarily used to control seizures and are not the first-line treatment for tremors in hyperthyroidism. Iodine compounds (Choice D) are used in the treatment of hyperthyroidism by reducing the production of thyroid hormones but are not specifically indicated for tremor relief.

5. A one-month-old infant in the neonatal intensive care unit is dying. The parents request that the nurse administer an opioid analgesic to their infant, who is crying weakly. The infant's heart rate is 68 beats per minute, and the respiratory rate is 18 breaths per minute. The infant is on room air, and the oxygen saturation is 92%. The nurse's response is based on which of the following principles?

• A. Providing analgesia during the last days and hours is an ethically appropriate nursing action.
• B. Withholding the opioid analgesia during the last days and hours is an ethical duty because administering it would represent assisted suicide.
• C. Administering analgesia during the last days and hours is the parents' ethical decision.
• D. Withholding the opioid analgesia is clinically appropriate because it will hasten the infant's death.

Correct answer: A

Rationale: All patients, regardless of age, have the right to die with dignity and be free from pain. In this case, the parents' request for an opioid analgesic to relieve the child's distress aligns with the principles of palliative care and ensuring comfort. Assisted suicide involves a conscious decision by the individual, which is not applicable to a 1-month-old infant. Both the nurse and the parents have an ethical duty to ensure the infant's comfort and well-being. Withholding opioid analgesia solely to hasten death is not appropriate, as providing pain relief is a crucial aspect of end-of-life care. Opioids can be administered to dying patients at any age to alleviate suffering without the intention of hastening death. Therefore, providing analgesia during the last days and hours is an ethically appropriate nursing action. Choices B, C, and D are incorrect because the decision to administer analgesia in this scenario is based on the best interest and comfort of the infant, not concerns about assisted suicide or hastening death. The ethical consideration is to provide compassionate care and alleviate suffering.

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