Nursing Elites

1. A client requests the creation of a living will. Which of the following actions should the nurse take?

• A. Schedule a meeting between the hospital ethics committee and the client
• B. Evaluate the client's understanding of life-sustaining measures
• C. Determine the client's preferences about post-mortem care
• D. Request a conference with the client's family

Correct answer: B

Rationale: The correct action for the nurse to take when a client requests the creation of a living will is to evaluate the client's understanding of life-sustaining measures. This step is crucial to ensure that the client is well-informed about their options before making decisions regarding their future care. Scheduling a meeting with the hospital ethics committee (choice A) may not be necessary at this stage and could overwhelm the client. Determining the client's preferences about post-mortem care (choice C) is not directly related to creating a living will. Requesting a conference with the client's family (choice D) may be important later but is not the initial step in this situation.

2. A client with heart failure is prescribed furosemide. What finding should the nurse report to the provider?

• A. Sodium 140 mEq/L
• B. Heart rate of 82/min
• C. Potassium level of 2.8 mEq/L
• D. Oxygen saturation 95%

Correct answer: C

Rationale: The correct answer is C. A potassium level of 2.8 mEq/L is low and should be reported to the provider. Furosemide can cause potassium depletion, leading to hypokalemia. Low potassium levels can result in cardiac dysrhythmias, which is a serious concern in clients with heart failure. Choices A, B, and D are within normal ranges and do not require immediate reporting. Sodium level of 140 mEq/L, heart rate of 82/min, and oxygen saturation of 95% are all acceptable findings.

3. A nurse is assisting with the development of an informed document for participation in a research study. Which of the following information should the nurse include?

• A. A statement that participants can leave the study at will.
• B. An assignment of the participant to either the experimental or control group.
• C. A list of the clients participating in the study.
• D. A description of the framework the researchers will use to evaluate the data.

Correct answer: A

Rationale: The correct answer is A: 'A statement that participants can leave the study at will.' This information is crucial to include in the informed document to ensure that participants are aware of their right to withdraw from the study at any time without any negative consequences. Choice B is incorrect because participants should not be assigned to experimental or control groups without their knowledge and consent. Choice C is incorrect because disclosing a list of clients participating in the study violates confidentiality. Choice D is incorrect as the description of the data evaluation framework is important but not as critical as ensuring participants know they can leave the study at will.

4. Which medication is commonly prescribed for a patient with hypertension?

• A. Lisinopril
• B. Metformin
• C. Atorvastatin
• D. Aspirin

Correct answer: A

Rationale: The correct answer is Lisinopril. Lisinopril is an ACE inhibitor commonly prescribed to patients with hypertension to manage their blood pressure. Metformin is used to treat type 2 diabetes, not hypertension (choice B). Atorvastatin is a statin used to lower cholesterol levels, not primarily prescribed for hypertension (choice C). Aspirin is used for its antiplatelet effects and in preventing cardiovascular events, but it is not a first-line treatment for hypertension (choice D). Therefore, Lisinopril is the most suitable choice for a patient with hypertension.

5. A nurse is assessing a client who has chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse expect?

• A. Increased oxygen saturation with exercise.
• B. Pursed-lip breathing with exertion.
• C. Productive cough with clear sputum.
• D. Clubbing of the fingers.

Correct answer: C

Rationale: The correct answer is C: 'Productive cough with clear sputum.' Clients with COPD often have a chronic productive cough with thick, often purulent sputum. This sputum can be white, yellow, green, or clear. Choices A, B, and D are incorrect. Oxygen saturation may decrease with exertion in COPD due to impaired gas exchange. Pursed-lip breathing is used to control dyspnea, not directly related to increased saturation with exercise. Clubbing of the fingers is typically seen in conditions such as cyanotic heart disease or lung cancer.

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