Nursing Elites

1. A nurse is caring for a client who is unconscious and whose partner is their health care surrogate. The partner wishes to discontinue the client's feeding tube, but another family member tells the nurse that they want the client to continue receiving treatment. Which of the following responses should the nurse make?

• A. You should contact the provider about your wishes for your family member.
• B. We'll need to have the nursing supervisor review the client's advance directives.
• C. You should speak with the facility's ethics committee about your concerns.
• D. As the health care surrogate, the client's partner can make this decision.

Correct answer: D

Rationale: The correct response is D because the health care surrogate, as designated by the client, has the legal authority to make healthcare decisions on behalf of the client when they are unable to do so. This authority includes decisions about treatment continuation or withdrawal. Option A is incorrect as the family member's wishes do not override the legal authority of the health care surrogate. Option B is not the most appropriate action in this situation as the advance directives are already clear by the designation of a health care surrogate. Option C is not necessary at this stage since the health care surrogate can make the decision without involving the ethics committee.

2. The doctor has ordered 500 mg of a medication PO once a day. The tablets on hand are labeled as 1 tablet = 250 mg. How many tablets will you administer to your patient?

• A. 1 Tablet
• B. 2 Tablets
• C. 3 Tablets
• D. 4 Tablets

Correct answer: B

Rationale: To calculate the number of tablets needed, divide the total dosage prescribed (500 mg) by the dosage per tablet (250 mg per tablet). 500 mg / 250 mg per tablet = 2 tablets. Therefore, the correct answer is 2 tablets. Choices A, C, and D are incorrect as they do not accurately reflect the correct calculation based on the provided information.

3. Nurse Andy has finished teaching a client with diabetes mellitus how to administer insulin. He evaluates the learning has occurred when the client makes which statement?

• A. I should check my blood sugar immediately prior to the administration.
• B. I should provide direct pressure over the site following the injection.
• C. I should use the abdominal area only for insulin injections.
• D. I should only use a calibrated insulin syringe for the injections.

Correct answer: D

Rationale: The correct answer is D because using a calibrated insulin syringe is crucial for accurate dosing when administering insulin. Choice A is incorrect because checking blood sugar before administration is essential but not the specific evaluation of learning in this context. Choice B is incorrect as applying direct pressure over the injection site is not a key indicator of learning about insulin administration. Choice C is incorrect as insulin injections can also be administered in other sites like the thigh or arm; it is not limited to the abdominal area.

4. What is the role of a nurse in a multidisciplinary healthcare team?

• A. Working independently without consulting others
• B. Coordinating patient care with other team members
• C. Ignoring patient concerns
• D. Making all healthcare decisions alone

Correct answer: B

Rationale: The correct answer is B: 'Coordinating patient care with other team members.' In a multidisciplinary healthcare team, nurses collaborate with other healthcare professionals to ensure comprehensive care for patients. Working independently without consulting others (choice A) is not aligned with the collaborative nature of multidisciplinary teams. Ignoring patient concerns (choice C) goes against the core principles of patient-centered care. Making all healthcare decisions alone (choice D) contradicts the teamwork approach of a multidisciplinary team.

5. A client with DM has an above-knee amputation because of severe peripheral vascular disease. Two days following surgery, when preparing the client for dinner, what is the nurse's primary responsibility?

• A. Check the client's serum glucose level
• B. Assist the client out of bed to the chair
• C. Place the client in a high-Fowler's position
• D. Ensure that the client's residual limb is elevated

Correct answer: A

Rationale: The correct answer is to check the client's serum glucose level. In a client with diabetes who just had surgery, monitoring the serum glucose level is crucial to ensure proper management of the condition. This helps in preventing complications related to blood sugar fluctuations. Assisting the client out of bed may be important but not the primary responsibility at this time. Placing the client in a high-Fowler's position or ensuring the residual limb is elevated are important interventions for comfort and circulation but are not the primary concern in this scenario.

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