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. A nurse manager in the emergency department considers policy changes in the organization and changes in the community, and tries to predict how these may impact the functioning of the unit. Which of the following decisional activities best describes this manager's actions?

• A. Resource allocation
• B. Monitoring
• C. Job analysis and redesign
• D. Planning for the future

Correct answer: D

Rationale: The correct answer is 'Planning for the future.' In this scenario, the nurse manager is engaging in strategic planning by considering policy changes and community dynamics to forecast potential impacts on the unit's functioning. This decisional activity involves anticipating future changes, challenges, and opportunities, and preparing the unit to adapt accordingly. Choice A, 'Resource allocation,' involves distributing resources effectively to support daily operations, which is not the primary focus of the nurse manager's actions described. Choice B, 'Monitoring,' typically involves overseeing current activities and performance to ensure adherence to standards and goals, rather than proactively planning for future changes as the nurse manager is doing. Choice C, 'Job analysis and redesign,' pertains to evaluating and modifying job roles and responsibilities within the unit, which is not directly related to the strategic forecasting and planning involved in anticipating organizational and community impacts.

3. Which of the following is a primary goal of nursing?

• A. Assist patients in achieving a peaceful death.
• B. Enhance personal knowledge and skills to improve patient outcomes.
• C. Champion quality of life over quantity of life.
• D. Manage costs to enhance patients' quality of life.

Correct answer: A

Rationale: The primary goal of nursing is to assist patients in achieving a peaceful death if recovery is not feasible. This involves providing comfort, dignity, and support during the end-of-life process. Choice B is incorrect because while improving personal knowledge and skills is important, it is not the primary goal of nursing. Choice C, advocating for quality of life over quantity of life, is a valid aspect of nursing care but may not always be the primary goal. Choice D, managing costs to enhance patients' quality of life, is not a primary goal of nursing, as the focus should primarily be on patient care and well-being, rather than financial considerations.

4. Scientific management and human relations-based approach are two major theoretical management schools of thought. Which of the following best describes the scientific model of management?

• A. A nurse manager considers methods of motivating the staff to do their assigned tasks.
• B. A nurse manager commends staff for the work they do, reminding them of the importance of their work and the lives they have saved.
• C. A nurse manager analyzes the role of each staff member on the unit to determine ways to increase efficiency.
• D. A conflict between two staff nurses has impacted an entire unit. The unit manager meets with the nurses and entire staff to promote mutual understanding.

Correct answer: C

Rationale: The correct answer is C because scientific management focuses on improving efficiency through the analysis of tasks and work processes. Choice A is more aligned with a human relations-based approach, which emphasizes motivation and relationships. Choice B reflects recognition and morale boosting, which is also characteristic of the human relations approach. Choice D involves conflict resolution and promoting mutual understanding, which is related to the human relations approach rather than scientific management.

5. A client with hyperparathyroidism is at risk for which of the following complications?

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

Correct answer: B

Rationale: A client with hyperparathyroidism is at risk for osteoporosis, not hypocalcemia, hypokalemia, or hyponatremia. Hyperparathyroidism results in increased levels of parathyroid hormone, which causes excessive breakdown of bone tissue to release calcium into the bloodstream. This process can lead to weakened bones and an increased risk of osteoporosis. Hypocalcemia is unlikely in hyperparathyroidism as the condition is characterized by elevated calcium levels due to the abnormal activity of the parathyroid glands. Hypokalemia and hyponatremia are not directly associated with hyperparathyroidism; they are more commonly linked to other conditions affecting potassium and sodium levels in the body.

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