Nursing Elites

1. A nurse is caring for a client with a diagnosis of terminal cancer. Which of the following statements by the client should indicate to the nurse that the client is ready to hear information regarding palliative care?

• A. "I am ready to learn about chemotherapy to help cure my cancer."
• B. "I just want you to give me something to get this over with soon."
• C. "I want you to tell me about measures available to keep me comfortable."
• D. "I know that many people have recovered fully from cancer, and so will I."

Correct answer: C

Rationale: Choice C is the correct answer because the client expressing a desire to know about measures available to keep comfortable indicates readiness for palliative care. Palliative care focuses on providing comfort, symptom management, and improving the quality of life for patients with serious illnesses such as terminal cancer. Choices A, B, and D are incorrect. Choice A indicates a desire for chemotherapy to cure the cancer, which does not align with palliative care goals. Choice B expresses a wish to end the situation quickly, which may not be in line with palliative care that focuses on comfort and quality of life. Choice D shows optimism about a full recovery, which may not be realistic for a client with terminal cancer who needs palliative care.

2. The time period to give as notice for an appraisal is:

• A. One day.
• B. None.
• C. One week.
• D. Two days.

Correct answer: D

Rationale: The correct answer is D: 'Two days.' It is preferable to give two days' notice for a performance appraisal. Giving only one day's notice (Choice A) might not provide sufficient time for the employee to prepare adequately for the appraisal. Choice B, 'None,' is incorrect because it is essential to give advance notice for an appraisal to allow the employee time to get ready. Choice C, 'One week,' is too long of a notice period for a standard performance appraisal and could lead to unnecessary delays.

3. Which laboratory value reported to the nurse by the unlicensed assistive personnel (UAP) indicates the most urgent need for the nurse�s assessment of the patient?

• A. Bedtime glucose of 140 mg/dL
• B. Noon blood glucose of 52 mg/dL
• C. Fasting blood glucose of 130 mg/dL
• D. 2-hr postprandial glucose of 220 mg/dL

Correct answer: B

Rationale:

4. How did the Social Security Act of 1935 impact public health nursing?

• A. Disabled children
• B. Mentally disabled
• C. Older adults
• D. Opioid addicts

Correct answer: A

Rationale: The Social Security Act of 1935 impacted public health nursing by containing provisions for care for disabled children. This helped in improving the health and well-being of this vulnerable population. The Act did not specifically address care for mentally disabled individuals, older adults, or opioid addicts. Therefore, the correct answer is disabled children.

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.

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