Nursing Elites

1. When considering a bone marrow transplant for a client with leukemia, which ethical principle pertains to minimizing harm to the client?

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

Correct answer: B

Rationale: The correct answer is B: Nonmaleficence. Nonmaleficence is the ethical principle that emphasizes the obligation to do no harm, making it crucial in medical decision-making. In the context of a bone marrow transplant for a client with leukemia, the primary concern is to minimize harm and avoid causing any unnecessary suffering or adverse effects. Choices A, C, and D are incorrect: Justice relates to fairness in resource allocation and treatment decisions, Autonomy involves respecting the patient's right to make decisions about their own care, and Beneficence refers to the obligation to act in the patient's best interest and promote their well-being, which may involve some level of risk or harm for overall benefit.

2. When administering IV fluids to a dehydrated patient, what is the nurse's priority assessment?

• A. Monitor the patient's electrolyte levels.
• B. Assess the patient's blood pressure regularly.
• C. Monitor the patient's heart rate every 4 hours.
• D. Check the patient's urine output hourly.

Correct answer: B

Rationale: The correct answer is to assess the patient's blood pressure regularly. Monitoring blood pressure is crucial when administering IV fluids to a dehydrated patient as it helps in evaluating the patient's fluid status. Changes in blood pressure can indicate the effectiveness of the fluid therapy, the patient's response to treatment, and the possibility of complications such as fluid overload or hypovolemia. Monitoring electrolyte levels (Choice A) is essential but not the priority when assessing a dehydrated patient receiving IV fluids. Heart rate (Choice C) should be monitored more frequently than every 4 hours in such a situation. Checking urine output (Choice D) is important but not as critical as assessing blood pressure in this scenario.

3. A nurse on a medical unit is preparing to discharge a client to home. Which of the following actions should the nurse take as part of the medication reconciliation process?

• A. Discontinue current medications
• B. Write new prescriptions
• C. Compare prescriptions with the client’s medications
• D. Ask the client to decide

Correct answer: C

Rationale: The correct action in the medication reconciliation process is to compare prescriptions with the client’s medications. This step ensures that there are no conflicting medications prescribed, reducing the risk of adverse drug interactions. Discontinuing current medications or writing new prescriptions without comparing them can lead to errors and potential harm. Asking the client to decide is not appropriate in this context as it is the nurse's responsibility to ensure medication safety based on professional judgment and knowledge.

4. A nurse is caring for a client who requires total parenteral nutrition (TPN). Which of the following actions should the nurse take when finding that the TPN solution is infusing too rapidly?

• A. Sit the client upright
• B. Stop the TPN infusion
• C. Turn the client on their left side
• D. Prepare to add insulin to the TPN infusion

Correct answer: B

Rationale: The correct action for the nurse to take when finding that the TPN solution is infusing too rapidly is to stop the TPN infusion. This is crucial to prevent fluid overload and ensure the client's safety. Sitting the client upright (Choice A) or turning the client on their left side (Choice C) are not appropriate responses to a rapidly infusing TPN solution and do not address the immediate issue of preventing complications from the rapid infusion. Adding insulin to the TPN infusion (Choice D) is not indicated unless specifically prescribed by the healthcare provider for the client's condition. Therefore, the priority action is to stop the TPN infusion to prevent potential harm.

5. A client is being prepared for discharge after a stroke. Which of the following interventions should be included in the discharge plan to prevent complications?

• A. Recommend physical therapy to improve mobility
• B. Teach the client how to use an incentive spirometer
• C. Encourage the client to ambulate daily
• D. Provide education on proper medication management

Correct answer: D

Rationale: The correct answer is to provide education on proper medication management. Proper medication management is crucial in reducing the risk of stroke recurrence and ensuring the client adheres to the treatment plan. While physical therapy, incentive spirometer use, and daily ambulation are important aspects of stroke rehabilitation, they are not directly related to preventing complications during the discharge phase.

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