Nursing Elites

1. A group of newly licensed nurses is being instructed by a nurse about the responsibilities that organ donation and procurement involve. When the nurse explains that all clients waiting for a kidney transplant have to meet the same qualifications, the newly licensed nurses should understand that this aspect of care delivery is an example of which of the following ethical principles?

• A. Fidelity
• B. Autonomy
• C. Justice
• D. Nonmaleficence

Correct answer: C

Rationale: The correct answer is 'C: Justice.' Justice in healthcare ethics involves fairness and providing equal treatment to all individuals in similar situations. In this scenario, ensuring that all clients waiting for a kidney transplant meet the same qualifications aligns with the principle of justice by offering equal opportunities for transplantation. Choice A, 'Fidelity,' pertains to keeping promises and being loyal to patients, not the equal treatment of individuals. Choice B, 'Autonomy,' refers to respecting patients' rights to make decisions about their own care, which is not directly related to the equal qualifications for kidney transplants. Choice D, 'Nonmaleficence,' focuses on the obligation to do no harm, which is important in healthcare but not the primary ethical principle demonstrated in this scenario.

2. The nurse is caring for a client diagnosed with hypothyroidism. Which finding should the nurse expect to observe?

• A. Weight gain
• B. Heat intolerance
• C. Increased appetite
• D. Frequent diarrhea

Correct answer: A

Rationale: The correct answer is weight gain. In hypothyroidism, there is a decrease in metabolic rate, which can lead to weight gain. Heat intolerance (choice B) is more commonly associated with hyperthyroidism. Increased appetite (choice C) and frequent diarrhea (choice D) are not typical findings in hypothyroidism. Therefore, choices B, C, and D are incorrect.

3. A nurse is counseling a young adult who describes having difficulty dealing with several issues. Which of the following statements should the nurse identify as the priority to assess further?

• A. “I have my own apartment now, but it’s not easy living away from my guardians.”
• B. “It’s been so stressful for me to even think about having my own family.”
• C. “I don’t even know who I am yet, and now I’m supposed to know what to do.”
• D. “My partner is pregnant, and I don’t think I have what it takes to be a good parent.”

Correct answer: D

Rationale: The statement about feeling unprepared to be a good parent indicates a significant concern that may need further assessment and support. This statement raises issues regarding the individual's readiness for parenthood and potential impact on the partner and the unborn child. Choices A, B, and C, while important, do not present immediate concerns regarding the well-being of another individual and do not raise potential risks that could have a direct impact on others.

4. A client who had a myocardial infarction (MI) 2 days ago has many questions about this condition. What area is a priority for the nurse to discuss at this time?

• A. Daily needs and concerns
• B. The overview of cardiac rehabilitation
• C. Medication and diet guidelines
• D. Activity and rest guidelines

Correct answer: A

Rationale: Addressing the client's daily needs and concerns is a priority to help alleviate anxiety and ensure the client understands the immediate post-MI care. Daily needs and concerns encompass basic aspects like comfort, hygiene, emotional support, and overall well-being, which are crucial in the early recovery phase post-MI. Discussing cardiac rehabilitation, medication and diet guidelines, or activity and rest guidelines are important topics but addressing immediate personal needs and concerns takes precedence to establish a supportive and informative care environment.

5. The client is receiving discharge instructions for warfarin (Coumadin). Which statement by the client indicates a need for further teaching?

• A. I will avoid eating foods high in vitamin K.
• B. I will have my blood tested regularly to monitor my INR levels.
• C. I will take the medication at the same time every day.
• D. I will use a soft toothbrush to prevent bleeding gums.

Correct answer: A

Rationale: The correct answer is A. Clients taking warfarin need to be consistent with their vitamin K intake to maintain a balance in blood clotting. Avoiding foods high in vitamin K is essential as they can interfere with the medication's effectiveness. Choices B, C, and D are all correct statements regarding warfarin therapy. Regular blood testing to monitor INR levels ensures the medication is working effectively, taking the medication at the same time daily maintains a consistent level in the bloodstream, and using a soft toothbrush helps prevent gum bleeding due to warfarin's anticoagulant effects.

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