Nursing Elites

1. A nurse is completing an admission assessment for a client who reports vomiting and diarrhea for the past 3 days. Which of the following findings should the nurse expect?

• A. Blood pressure 144/82 mm Hg
• B. Urine specific gravity 1.03
• C. Neck vein distention
• D. Urine specific gravity 1.01

Correct answer: A

Rationale: In a client experiencing vomiting and diarrhea, the nurse should expect findings such as dehydration, which can lead to hypovolemia and subsequent increased heart rate and decreased blood pressure. A blood pressure of 144/82 mm Hg is indicative of possible dehydration in this client. Urine specific gravity is typically increased in dehydrated individuals, so choices B and D are incorrect. Neck vein distention is not a typical finding associated with vomiting and diarrhea; therefore, choice C is also incorrect.

2. A nurse has a seriously ill parent and must take care of the parent at home. Which of the following would NOT be a suitable solution to this problem? (EXCEPT)

• A. Resignation
• B. FMLA
• C. Termination
• D. LOA

Correct answer: C

Rationale: FMLA (Family and Medical Leave Act) provides up to 12 weeks of unpaid, job-protected leave to care for a seriously ill family member, securing the employee's job status. Termination and resignation involve ending employment, which is not a suitable solution as it does not provide job security. LOA (Leave of Absence) is often unpaid and does not guarantee job protection, making it less suitable than FMLA in this scenario.

3. An RN is working through an ethical dilemma involving a patient on his unit. He has just identified the decision makers involved. Which step best describes the current stage the RN is working through?

• A. Assessment
• B. Diagnosis
• C. Planning
• D. Implementation

Correct answer: C

Rationale: The correct answer is C: Planning. In the planning phase of addressing an ethical dilemma, the goals of treatment are established, decision makers are identified, and all available options are reviewed. The assessment phase involves collecting data and information, the diagnosis phase involves analyzing the information to identify the problem, and the implementation phase involves carrying out the chosen plan of action. Therefore, in this scenario, where decision makers are being identified, the RN is in the planning stage.

4. A 38-year-old patient who has type 1 diabetes plans to swim laps daily at 1:00 PM. The clinic nurse will plan to teach the patient to

• A. check glucose levels before, during, and after swimming.
• B. delay eating the noon meal until after swimming.
• C. increase the morning dose of neutral protamine Hagedorn (NPH) insulin.
• D. time the morning insulin injection so that the peak occurs while swimming.

Correct answer: A

Rationale: The correct answer is to teach the patient to check glucose levels before, during, and after swimming. This is important to monitor blood sugar levels and make adjustments as needed to prevent hypoglycemia or hyperglycemia. Delaying eating the noon meal until after swimming (Choice B) is not advisable as the patient needs proper nutrition both before and after exercise. Increasing the morning dose of NPH insulin (Choice C) should not be done without proper medical advice as it can lead to hypoglycemia. Timing the morning insulin injection to coincide with swimming (Choice D) is risky as the peak effect of insulin may lead to hypoglycemia during swimming.

5. Which information is most important for the nurse to report to the health care provider before a patient with type 2 diabetes is prepared for a coronary angiogram?

• A. The patient’s most recent HbA1C was 6.5%
• B. The patient’s admission blood glucose is 128 mg/dL.
• C. The patient took the prescribed metformin (Glucophage) today
• D. The patient took the prescribed captopril (Capoten) this morning.

Correct answer: C

Rationale:

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