Nursing Elites

1. A nurse is assigned to care for a group of clients. On review of the clients' medical records, the nurse determines that which client is at risk for excess fluid volume?

• A. The client taking diuretics
• B. The client with renal failure
• C. The client with an ileostomy
• D. The client who requires gastrointestinal suctioning

Correct answer: B

Rationale: The correct answer is B. Clients with renal failure are unable to excrete fluids effectively, leading to an increased risk of fluid volume excess. Option A, the client taking diuretics, would be at risk for fluid volume deficit due to increased urine output caused by the diuretics. Option C, the client with an ileostomy, is at risk for fluid volume deficit due to increased output from the ileostomy. Option D, the client who requires gastrointestinal suctioning, may be at risk for dehydration, but not specifically excess fluid volume.

2. The client has been diagnosed with primary aldosteronism. Which of the following clinical findings would the nurse expect?

• A. Hyperkalemia
• B. Hypokalemia
• C. Hyponatremia
• D. Hypercalcemia

Correct answer: B

Rationale: Primary aldosteronism involves the overproduction of aldosterone by the adrenal glands. Aldosterone increases potassium excretion, leading to hypokalemia. Therefore, in primary aldosteronism, the nurse would expect to find hypokalemia, not hyperkalemia (choice A), hyponatremia (choice C), or hypercalcemia (choice D).

3. Which of the following statements is true regarding followership and leadership?

• A. Effective leadership is more important than followership.
• B. Good leaders do not need to be good followers.
• C. A good follower is not just skilled but also self-directed.
• D. Critical thinking is only required for effective leadership.

Correct answer: C

Rationale: The correct answer is C: 'A good follower is not just skilled but also self-directed.' This statement is true as being self-directed complements effective leadership. Good followers possess the ability to take initiative, work independently, and contribute positively to a team without constant supervision. Option A is incorrect because followership is equally important as leadership in achieving group success. Option B is incorrect as good leaders often demonstrate qualities of good followership, such as being able to listen, collaborate, and support others. Option D is incorrect because critical thinking is essential for both effective leadership and followership, not exclusively for leadership roles.

4. Nurse managers need several qualities to be effective. A nurse manager is working hard to fully understand how patient outcomes are measured on the unit and how budget changes could impact patient outcomes. Which of the following qualities does this best describe?

• A. Leadership
• B. Business sense
• C. Clinical expertise
• D. Financial management

Correct answer: B

Rationale: The correct answer is 'Business sense.' Nurse managers need to understand how financial decisions impact patient outcomes, which requires a strong understanding of business principles. Leadership (choice A) is important but doesn't specifically address understanding financial and outcome-based impacts. Clinical expertise (choice C) is essential for patient care but doesn't directly relate to understanding budget changes and their impact. Financial management (choice D) is more about managing finances directly rather than understanding the broader implications of budget changes on patient outcomes.

5. A client at risk for hypokalemia is being instructed by a nurse about foods high in potassium that should be included in the daily diet. The nurse determines that the client understands the food sources of potassium if the client states that the food item lowest in potassium is:

• A. Apples
• B. Carrots
• C. Spinach
• D. Avocado

Correct answer: A

Rationale: The correct answer is 'Apples.' Apples are the lowest in potassium among the given options. Carrots, spinach, and avocados are all higher in potassium content compared to apples. Carrots and spinach are vegetables known to have a moderate amount of potassium. Avocados, on the other hand, are a high-potassium fruit and would not be the lowest in potassium among the choices provided.

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