Nursing Elites

1. A client with diabetes mellitus is experiencing polyuria, polydipsia, and polyphagia. Which of the following actions should the nurse take?

• A. Administer insulin
• B. Encourage increased fluid intake
• C. Monitor for signs of dehydration
• D. Check blood glucose levels

Correct answer: D

Rationale: Polyuria, polydipsia, and polyphagia are classic signs of hyperglycemia, indicating high blood glucose levels. The priority action for the nurse is to check the client's blood glucose levels to assess the severity of hyperglycemia and determine the need for appropriate interventions. Administering insulin (Choice A) may be necessary based on the blood glucose levels but should only be done after confirming the current status. Encouraging increased fluid intake (Choice B) may exacerbate the symptoms by further diluting the blood glucose concentration. While monitoring for signs of dehydration (Choice C) is important in the long term, the immediate action should focus on determining the blood glucose levels first.

2. Which of the following statements should be included in the teaching to a client about a do-not-resuscitate order (DNR)?

• A. When a heart ceases to beat, the client is pronounced clinically dead.
• B. Physicians are required to write DNR orders.
• C. A DNR order can be written after discussion with the client and family.
• D. A court decision is needed for a DNR.

Correct answer: C

Rationale: The correct statement to include in teaching a client about a do-not-resuscitate (DNR) order is that it can be written after discussion with the client and family. This involves ensuring that the client and their family understand the implications and make an informed decision. Choice A is incorrect as pronouncing clinical death is not directly related to discussing a DNR order. Choice B is incorrect as while physicians typically write DNR orders, it is not a strict requirement. Choice D is incorrect as a court decision is not typically required for a DNR order; it is a decision made by the client with input from healthcare providers and family members.

3. A healthcare professional is experiencing moral distress due to an ethical dilemma. Which of the following best describes the healthcare professional’s response to this situation?

• A. The healthcare professional is experiencing moral distress because the ethical dilemma is causing a conflict between the healthcare professional’s personal values and professional responsibilities.
• B. The healthcare professional is experiencing moral distress because the ethical dilemma is causing a conflict between the healthcare professional’s obligations to the patient and the healthcare team.
• C. The healthcare professional is experiencing moral distress because the ethical dilemma is causing a conflict between the healthcare professional’s personal beliefs and the expectations of the healthcare organization.
• D. The healthcare professional is experiencing moral distress because the ethical dilemma is causing a conflict between the healthcare professional’s professional judgment and the wishes of the patient’s family.

Correct answer: A

Rationale: Moral distress occurs when a healthcare professional experiences a conflict between personal values and professional responsibilities, leading to emotional and ethical challenges. Choice B is incorrect because moral distress is primarily related to personal values and professional responsibilities, not just obligations to the patient and healthcare team. Choice C is incorrect because moral distress is more about personal values and professional responsibilities, rather than organizational expectations. Choice D is incorrect because moral distress is focused on personal values and professional responsibilities, not just conflicts with the wishes of the patient’s family.

4. A client with type 2 DM is being treated with metformin (Glucophage). The nurse should include which instruction when teaching the client about this medication?

• A. Take the medication with meals.
• B. Take the medication on an empty stomach.
• C. Take the medication before bedtime.
• D. Avoid taking the medication if you miss a meal.

Correct answer: A

Rationale: The correct instruction for a client taking metformin (Glucophage) is to take the medication with meals. This helps reduce gastrointestinal side effects and improves absorption. Choice B is incorrect because taking metformin on an empty stomach can increase the risk of side effects. Choice C is incorrect as there is no specific recommendation to take metformin before bedtime. Choice D is incorrect as missing a meal should not lead to avoiding the medication, but the client should take it with the next meal as prescribed.

5. Which of the following statements is true regarding ethical principles and laws?

• A. The government enforces ethics.
• B. Laws establish standards that aid in decision-making.
• C. Ethics are highly specific.
• D. Ethical principles can serve as the foundation for laws.

Correct answer: D

Rationale: The correct answer is D. Ethical principles can influence the creation of laws but are not equivalent to laws themselves. Laws are established by governing bodies to provide a framework for society, whereas ethical principles guide individuals' moral conduct. Choice A is incorrect because governments enforce laws, not ethics. Choice B is incorrect as laws set legal standards rather than ethical ones. Choice C is incorrect because ethics are principles that guide behavior but are not necessarily highly specific.

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