Nursing Elites

1. When a client with a terminal diagnosis asks about advance directives, what should the nurse do?

• A. Engage the client and ask why they want to discuss this without their partner present.
• B. Provide information on advance directives and offer brochures.
• C. Advise the client to schedule a discussion with their provider.
• D. Focus on the client's current feelings and postpone planning for a later time.

Correct answer: A

Rationale: Choice A is the correct response as it demonstrates active listening and empathy by engaging the client in a discussion about their concerns regarding advance directives. It also recognizes the importance of involving the client's partner in such discussions, promoting shared decision-making and support. Choices B and C lack the personalized approach needed in this situation and do not address the client's immediate request for information. Choice D is incorrect as it disregards the client's expressed need to discuss advance directives and focuses solely on their current feelings, delaying a crucial conversation.

2. After change-of-shift report, which patient should the nurse assess first?

• A. 19-year-old with type 1 diabetes who was admitted with possible dawn phenomenon
• B. 35-year-old with type 1 diabetes whose most recent blood glucose reading was 230 mg/dL
• C. 60-year-old with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa
• D. 68-year-old with type 2 diabetes who has severe peripheral neuropathy and complains of burning foot pain

Correct answer: C

Rationale: The patient with hyperosmolar hyperglycemic syndrome who presents with poor skin turgor and dry oral mucosa requires immediate attention. These signs indicate severe dehydration and potential electrolyte imbalances, which can lead to serious complications. Assessing this patient first allows for prompt intervention and monitoring to stabilize their condition. Choice A is less urgent as the patient has possible dawn phenomenon, which is a common early-morning rise in blood glucose levels. Choice B, with a blood glucose reading of 230 mg/dL, indicates hyperglycemia but does not present with signs of severe dehydration like the patient in choice C. Choice D, with peripheral neuropathy and foot pain, is important but not as urgent as addressing severe dehydration and electrolyte imbalances in the patient with hyperosmolar hyperglycemic syndrome.

3. What is the primary focus of a performance appraisal for nursing staff?

• A. To identify areas for salary increases
• B. To evaluate overall job performance
• C. To provide feedback on clinical skills
• D. To determine eligibility for promotions

Correct answer: C

Rationale: The primary focus of a performance appraisal for nursing staff is to provide feedback on clinical skills, identify areas for improvement, and support professional development. While salary increases, overall job performance evaluation, and promotions may be factors considered during a performance appraisal, the primary goal is to assess and enhance clinical skills to ensure high-quality patient care.

4. Which of the following is an example of an effective conflict resolution strategy?

• A. Ignoring the conflict
• B. Assigning blame to one party
• C. Encouraging open communication
• D. Enforcing strict rules

Correct answer: C

Rationale: Encouraging open communication is an effective conflict resolution strategy because it promotes transparency, understanding, and collaboration among individuals involved in the conflict. By encouraging open communication, parties can express their perspectives, concerns, and needs, leading to the identification of common ground and potential solutions. This approach fosters a positive and constructive environment for resolving conflicts and can help prevent misunderstandings and escalation of issues. Choices A, B, and D are not effective conflict resolution strategies. Ignoring the conflict can lead to unresolved issues, assigning blame can escalate tensions and hinder problem-solving, and enforcing strict rules may not address the underlying causes of the conflict or promote mutual understanding.

5. An unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS). The nurse will anticipate the need to

• A. give a bolus of 50% dextrose.
• B. insert a large-bore IV catheter.
• C. initiate oxygen via nasal cannula.
• D. administer glargine (Lantus) insulin.

Correct answer: B

Rationale: In a patient with hyperosmolar hyperglycemic syndrome (HHS), severe dehydration and electrolyte imbalances are common. To address these issues, the priority intervention is to insert a large-bore IV catheter for fluid resuscitation and electrolyte replacement. Giving a bolus of 50% dextrose would worsen the hyperglycemia. Initiating oxygen via nasal cannula may be beneficial for respiratory support but is not the priority in this scenario. Administering glargine (Lantus) insulin is not the initial treatment for HHS as it does not address the underlying severe dehydration and electrolyte imbalances.

Similar Questions