Nursing Elites

1. A healthcare professional is experiencing moral distress due to an ethical dilemma. Which of the following best describes the healthcare professional’s response to this situation?

• A. The healthcare professional is experiencing moral distress because the ethical dilemma is causing a conflict between the healthcare professional’s personal values and professional responsibilities.
• B. The healthcare professional is experiencing moral distress because the ethical dilemma is causing a conflict between the healthcare professional’s obligations to the patient and the healthcare team.
• C. The healthcare professional is experiencing moral distress because the ethical dilemma is causing a conflict between the healthcare professional’s personal beliefs and the expectations of the healthcare organization.
• D. The healthcare professional is experiencing moral distress because the ethical dilemma is causing a conflict between the healthcare professional’s professional judgment and the wishes of the patient’s family.

Correct answer: A

Rationale: Moral distress occurs when a healthcare professional experiences a conflict between personal values and professional responsibilities, leading to emotional and ethical challenges. Choice B is incorrect because moral distress is primarily related to personal values and professional responsibilities, not just obligations to the patient and healthcare team. Choice C is incorrect because moral distress is more about personal values and professional responsibilities, rather than organizational expectations. Choice D is incorrect because moral distress is focused on personal values and professional responsibilities, not just conflicts with the wishes of the patient’s family.

2. For a male client with hyperglycemia, which assessment finding best supports a nursing diagnosis of Deficient fluid volume?

• A. Cool, clammy skin
• B. Distended neck veins
• C. Increased urine osmolarity
• D. Decreased serum sodium level

Correct answer: C

Rationale: Increased urine osmolarity is the best assessment finding supporting a nursing diagnosis of Deficient fluid volume in a male client with hyperglycemia. In hyperglycemia, there is increased glucose in the blood, which leads to osmotic diuresis. This results in the excretion of large amounts of urine that is concentrated (high osmolarity), leading to dehydration and fluid volume deficit. Cool, clammy skin (Choice A) is more indicative of poor perfusion, distended neck veins (Choice B) are associated with fluid volume excess, and decreased serum sodium level (Choice D) could be a result of dilutional hyponatremia due to fluid overload rather than deficient fluid volume.

3. A nurse is assigned to care for a group of clients. On reviewing the clients' medical records, the nurse determines that which client is at risk for deficient fluid volume?

• A. A client with a colostomy
• B. A client with congestive heart failure
• C. A client with decreased kidney function
• D. A client receiving frequent wound irrigations

Correct answer: A

Rationale: The correct answer is A. Clients with a colostomy are at risk for deficient fluid volume due to the loss of fluid through the colostomy. In colostomy, there can be increased fluid loss through the stoma, which may lead to dehydration and electrolyte imbalances. Choices B, C, and D do not directly relate to the risk for deficient fluid volume. Clients with congestive heart failure are more prone to fluid overload rather than deficient volume. Clients with decreased kidney function are at risk for fluid retention, not deficient volume. Clients receiving frequent wound irrigations may be at risk for infection, but this does not directly indicate deficient fluid volume.

4. The healthcare provider is assessing a client with hypothyroidism. Which of the following symptoms would the provider expect to find?

• A. Weight loss
• B. Heat intolerance
• C. Bradycardia
• D. Diarrhea

Correct answer: C

Rationale: Bradycardia is a common symptom of hypothyroidism because the condition leads to a decreased metabolic rate. Weight loss (Choice A) is more commonly associated with hyperthyroidism, where the metabolic rate is increased. Heat intolerance (Choice B) is also more indicative of hyperthyroidism due to increased sensitivity to heat. Diarrhea (Choice D) is not a typical symptom of hypothyroidism; rather, constipation is more common due to the slow-down of the digestive system.

5. A client with type 2 DM is being treated with metformin (Glucophage). The nurse should include which instruction when teaching the client about this medication?

• A. Take the medication with meals.
• B. Take the medication on an empty stomach.
• C. Take the medication before bedtime.
• D. Avoid taking the medication if you miss a meal.

Correct answer: A

Rationale: The correct instruction for a client taking metformin (Glucophage) is to take the medication with meals. This helps reduce gastrointestinal side effects and improves absorption. Choice B is incorrect because taking metformin on an empty stomach can increase the risk of side effects. Choice C is incorrect as there is no specific recommendation to take metformin before bedtime. Choice D is incorrect as missing a meal should not lead to avoiding the medication, but the client should take it with the next meal as prescribed.

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