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. What clinical feature distinguishes a hypoglycemic reaction from a ketoacidosis reaction?

• A. Blurred vision.
• B. Diaphoresis.
• C. Nausea.
• D. Weakness.

Correct answer: B

Rationale: Diaphoresis is the correct answer because it is more characteristic of hypoglycemia. Hypoglycemia typically presents with symptoms such as diaphoresis (excessive sweating), palpitations, tremors, and anxiety. On the other hand, ketoacidosis is associated with symptoms such as fruity breath, deep and labored breathing (Kussmaul respirations), nausea, vomiting, and abdominal pain. Blurred vision can occur in both hypoglycemia and ketoacidosis due to metabolic disturbances affecting the eyes. Weakness is a nonspecific symptom that can be present in both conditions, making it less helpful in distinguishing between the two.

3. A client with DM is scheduled for surgery. The nurse should plan to:

• A. Monitor the client's blood glucose level closely during the perioperative period.
• B. Give the client a regular diet as ordered.
• C. Have the client stop taking insulin 48 hours before surgery.
• D. Hold the client's insulin on the morning of surgery.

Correct answer: A

Rationale: The correct answer is to monitor the client's blood glucose level closely during the perioperative period. For a client with diabetes mellitus (DM) scheduled for surgery, it is essential to closely monitor blood glucose levels to prevent hypo- or hyperglycemia. Choice B is incorrect because giving the client a regular diet as ordered may not address the specific needs related to managing blood glucose levels in the perioperative period. Choice C is incorrect as abruptly stopping insulin 48 hours before surgery can lead to uncontrolled blood sugar levels, which is not recommended. Choice D is incorrect because holding the client's insulin on the morning of surgery can also disrupt blood sugar control, potentially leading to complications during the perioperative period.

4. Which of the following describes an effective method of communication?

• A. A unit manager meets with a new nurse to discuss what is going well and areas for improvement.
• B. A unit manager meets with a new nurse to explain departmental policies.
• C. A unit manager meets with staff after several safety events to introduce new policies aimed at preventing further safety events.
• D. A unit manager describes safety events that have occurred on the unit to another nurse manager and discusses ideas for policy improvement with the other manager.

Correct answer: A

Rationale: Choice A is the correct answer because it describes an effective method of communication where a unit manager meets with a new nurse to discuss what is going well and areas for improvement. This approach fosters open dialogue, provides constructive feedback, and promotes professional growth. Choice B is incorrect as it only involves the explanation of departmental policies without engaging in a two-way communication process. Choice C is incorrect as it focuses on policy introduction after safety events rather than individual feedback. Choice D is incorrect as it involves discussing safety events with another manager and policy improvement, but it does not directly address individual performance feedback, which is essential for effective communication and professional development.

5. The client has hyperparathyroidism. Which of the following lab findings is consistent with this condition?

• A. Hypocalcemia
• B. Hypercalcemia
• C. Hypokalemia
• D. Hyperphosphatemia

Correct answer: B

Rationale: Hyperparathyroidism leads to increased secretion of parathyroid hormone, which results in elevated calcium levels in the blood (hypercalcemia). Therefore, the correct lab finding consistent with hyperparathyroidism is hypercalcemia (Choice B). Hypocalcemia (Choice A) is not indicative of hyperparathyroidism as the condition is associated with high calcium levels. Hypokalemia (Choice C) is a low potassium level, which is not typically associated with hyperparathyroidism. Hyperphosphatemia (Choice D) refers to high phosphate levels and is not a characteristic finding in hyperparathyroidism.

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