Nursing Elites

1. A client with type 1 diabetes mellitus presents with nausea, vomiting, and abdominal pain. The nurse suspects diabetic ketoacidosis (DKA). Which of the following lab findings would confirm this diagnosis?

• A. Serum glucose of 180 mg/dL
• B. Serum bicarbonate of 22 mEq/L
• C. Blood pH of 7.25
• D. Urine specific gravity of 1.020

Correct answer: C

Rationale: A blood pH of 7.25 is a critical finding in diabetic ketoacidosis (DKA) as it indicates metabolic acidosis, which is a hallmark of this condition. In DKA, there is an accumulation of ketones in the blood, leading to increased acidity. The serum glucose level is typically elevated in DKA, often exceeding 250 mg/dL. A serum bicarbonate level less than 18 mEq/L is usually seen in DKA due to the metabolic acidosis. Urine specific gravity is not a specific indicator for DKA and may vary depending on the individual's hydration status. Therefore, the correct lab finding that confirms DKA in this scenario is a blood pH of 7.25.

2. The nurse is caring for a client with hyperaldosteronism. Which of the following laboratory results would the nurse expect?

• A. Hypokalemia
• B. Hypernatremia
• C. Hyperkalemia
• D. Hypocalcemia

Correct answer: A

Rationale: In hyperaldosteronism, there is an excess of aldosterone production, leading to increased sodium retention and potassium excretion by the kidneys. This results in hypokalemia (low potassium levels). Therefore, the correct answer is hypokalemia (Choice A). Hypernatremia (Choice B) is an incorrect choice as hyperaldosteronism primarily affects potassium and not sodium levels. Hyperkalemia (Choice C) is also incorrect because hyperaldosteronism causes potassium excretion, leading to low levels. Hypocalcemia (Choice D) is not typically associated with hyperaldosteronism; instead, it is more related to conditions affecting calcium regulation.

3. Which of the following is true about nursing ethics?

• A. Nursing ethics focus on the organizational level at the workplace.
• B. Nursing ethics focus on the moral character of nurses.
• C. Nursing ethics focus on the experiences and needs of patients.
• D. Nursing ethics focus on the ethical principles governing healthcare organizations.

Correct answer: B

Rationale: The correct answer is B. Nursing ethics primarily focus on the moral character of nurses, emphasizing principles, values, and virtues that guide their professional conduct. Choice A is incorrect as nursing ethics are more about individual moral decision-making than organizational practices. Choice C is incorrect because while nurses consider patients' experiences and needs, nursing ethics primarily revolve around the nurses themselves. Choice D is incorrect as nursing ethics are centered on the moral obligations and responsibilities of nurses, not specifically on the ethical principles governing healthcare organizations.

4. A client with diabetes mellitus is being educated on the importance of foot care. Which of the following instructions should the nurse include?

• A. Soak your feet daily to maintain cleanliness.
• B. Wear tight-fitting shoes to protect your feet.
• C. Apply lotion between your toes to prevent dryness.
• D. Inspect your feet daily for any cuts or sores.

Correct answer: D

Rationale: The correct answer is to instruct the client to inspect their feet daily for any cuts or sores. This is crucial for individuals with diabetes as they are at a higher risk of developing foot problems. Soaking feet daily can lead to skin breakdown and infections, making choice A incorrect. Tight-fitting shoes can cause pressure points and increase the risk of foot injuries, so choice B is incorrect. Applying lotion between the toes can create a moist environment, increasing the risk of fungal infections, making choice C incorrect.

5. A psychological contract exists between staff members and nurse managers. Which of the following best describes this relationship?

• A. Nurse managers provide positive evaluations, and in turn, staff members do what managers ask of them.
• B. Nurse managers coordinate multiple departments and supervise multiple staff members.
• C. Staff members do what managers ask of them and, in turn, are rewarded through assignments, promotions, and evaluations.
• D. Nurse managers advocate for staff and support nursing roles and ethical practice.

Correct answer: C

Rationale: The correct answer is C. In a psychological contract between staff members and nurse managers, staff members are expected to fulfill the requests of managers, and in return, they are rewarded with assignments, promotions, and evaluations. This reciprocal relationship forms the basis of the psychological contract. Choices A, B, and D are incorrect because they do not accurately capture the essence of the psychological contract. While nurse managers may provide positive evaluations, coordinate departments, supervise staff, advocate for staff, and support nursing roles, these actions alone do not define the specific reciprocal nature of the psychological contract outlined in choice C.

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