Nursing Elites

1. A nurse is caring for a client who has received a new diagnosis of terminal cancer. The client tells the nurse, 'I just want to live long enough to see my child graduate.' The nurse should identify that the client is in which of the following stages of grief?

• A. Denial
• B. Bargaining
• C. Acceptance
• D. Anger

Correct answer: B

Rationale: The client expressing a desire to live long enough to see their child graduate is an example of bargaining, which is a stage of grief where individuals attempt to negotiate for more time or different outcomes. Denial refers to refusing to accept the reality of the situation, acceptance involves coming to terms with the diagnosis, and anger is feeling frustrated and upset about the situation. Therefore, the correct answer is 'Bargaining.'

2. A nurse is teaching a client who has diabetes mellitus about foot care. Which of the following instructions should the nurse include?

• A. Soak your feet in warm water every day to prevent dryness.
• B. Wear cotton socks to keep your feet dry.
• C. Apply lotion between your toes after bathing.
• D. Cut your toenails in a rounded shape.

Correct answer: B

Rationale: The correct instruction the nurse should include is to 'Wear cotton socks to keep your feet dry.' This is essential in diabetes mellitus as moisture can lead to infections. Choice A is incorrect as soaking feet in warm water can actually cause dryness and skin breakdown, which is harmful in diabetes. Choice C is incorrect as applying lotion between the toes can create excess moisture, increasing the risk of fungal infections. Choice D is incorrect as cutting toenails in a rounded shape can lead to ingrown toenails; clients with diabetes should cut their nails straight across to prevent complications.

3. Which electrolyte imbalance is most concerning in a patient on furosemide?

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

Correct answer: B

Rationale: The correct answer is Hypokalemia. Furosemide is a loop diuretic that can lead to potassium depletion by increasing its excretion in the urine. Hypokalemia is a common and concerning side effect of furosemide therapy. Hyperkalemia (Choice A) is less likely as furosemide tends to lower potassium levels. Hyponatremia (Choice C) is more commonly seen with thiazide diuretics. Hypercalcemia (Choice D) is not directly associated with furosemide use.

4. A healthcare provider is assessing a newborn who has a patent ductus arteriosus. Which of the following findings should the provider expect?

• A. Continuous murmur.
• B. Absent peripheral pulses.
• C. Increased blood pressure.
• D. Bounding pulses.

Correct answer: A

Rationale: A continuous murmur is a classic finding in a newborn with patent ductus arteriosus. This murmur is typically heard between the first and second heart sounds and throughout systole. Absent peripheral pulses (choice B) are not typically associated with patent ductus arteriosus. Increased blood pressure (choice C) and bounding pulses (choice D) are not commonly seen with this condition. Therefore, the correct answer is A.

5. What is the priority nursing intervention for a patient experiencing respiratory distress?

• A. Administer oxygen
• B. Reposition the patient
• C. Administer bronchodilators
• D. Administer IV fluids

Correct answer: A

Rationale: The correct answer is to administer oxygen. In a patient experiencing respiratory distress, ensuring adequate oxygenation is the priority. Administering oxygen helps improve oxygen levels, which is crucial for the patient's well-being. Repositioning the patient, administering bronchodilators, or giving IV fluids are important interventions in certain situations, but when a patient is in respiratory distress, providing oxygen takes precedence over other actions.

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