Nursing Elites

1. A nurse is instructing a group of nursing students about the responsibilities involved with organ donation and procurement. When the nurse explains that all clients waiting for a kidney transplant have to meet the same qualifications, the students should understand that this aspect of care delivery is an example of which ethical principle?

• A. Fidelity
• B. Autonomy
• C. Justice
• D. Non-maleficence

Correct answer: C

Rationale: The correct answer is C: Justice. Justice in healthcare ethics refers to fairness and equality in the distribution of resources and treatments. In this scenario, ensuring that all clients waiting for a kidney transplant meet the same qualifications demonstrates the ethical principle of justice by providing equal opportunities for all candidates. Choice A, fidelity, pertains to keeping promises and being faithful to agreements, which is not the primary ethical principle at play in this situation. Autonomy, choice B, relates to respecting a patient's right to make their own decisions, which is not directly applicable in the context of organ transplant qualifications. Non-maleficence, choice D, refers to the principle of doing no harm, which is important but not the primary ethical principle highlighted in this scenario.

2. A healthcare professional is reviewing the medical records of a client who has a pressure ulcer. Which of the following is an expected finding?

• A. Serum albumin level of 3 g/dL
• B. HDL level of 90 mg/dL
• C. Norton scale score of 18
• D. Braden scale score of 20

Correct answer: A

Rationale: A serum albumin level of 3 g/dL is indicative of poor nutrition, which is commonly associated with pressure ulcers. This finding suggests that the client may be at risk for developing or already has a pressure ulcer due to malnutrition. High-density lipoprotein (HDL) level of 90 mg/dL (Choice B) is not directly related to pressure ulcers. The Norton scale (Choice C) is used to assess a client's risk of developing pressure ulcers, not as a finding in a client with an existing pressure ulcer. The Braden scale (Choice D) is also a tool used to assess the risk of developing pressure ulcers, not a finding in a client with an existing pressure ulcer.

3. A nurse is assessing a client who is prescribed spironolactone. Which of the following laboratory values should the nurse monitor for this client?

• A. Total bilirubin.
• B. Urine ketones.
• C. Serum potassium.
• D. Platelet count.

Correct answer: C

Rationale: The correct answer is C: Serum potassium. Spironolactone is a potassium-sparing diuretic, meaning it helps the body retain potassium. Therefore, the nurse should monitor the client's serum potassium levels to prevent hyperkalemia, which can be a potential side effect of spironolactone. Monitoring total bilirubin levels (A) is not specifically required for clients taking spironolactone. Urine ketones (B) are not directly influenced by spironolactone use. Platelet count (D) is not typically monitored in clients taking spironolactone.

4. What should be included in dietary teaching for a client with chronic kidney disease?

• A. Increase potassium-rich foods in the diet
• B. Limit phosphorus and potassium intake
• C. Encourage protein-rich foods to improve nutrition
• D. Increase calcium-rich foods in the diet

Correct answer: B

Rationale: The correct answer is to limit phosphorus and potassium intake for a client with chronic kidney disease. In renal insufficiency, the kidneys struggle to excrete these minerals, leading to their buildup in the blood, which can be harmful. Limiting phosphorus and potassium intake helps prevent further kidney damage and manage the progression of chronic kidney disease. Encouraging protein-rich foods (Choice C) may be counterproductive as excessive protein intake can burden the kidneys. Increasing potassium-rich foods (Choice A) is incorrect as high potassium levels can be detrimental in kidney disease. Increasing calcium-rich foods (Choice D) is not typically a focus in dietary teaching for chronic kidney disease unless there is a specific deficiency or need, as excessive calcium intake can also be harmful to kidney function.

5. What are the nursing interventions for a patient with hypokalemia?

• A. Administer potassium supplements and monitor ECG
• B. Provide a high-sodium diet and monitor for hypertension
• C. Monitor for muscle weakness and provide dietary education
• D. Administer diuretics and provide oral fluids

Correct answer: A

Rationale: The correct intervention for a patient with hypokalemia is to administer potassium supplements and monitor the ECG. Potassium supplements help correct the low potassium levels in the body, while ECG monitoring is essential to detect any cardiac arrhythmias associated with hypokalemia. Choice B is incorrect because a high-sodium diet would worsen hypokalemia by further depleting potassium levels. Choice C is incorrect as it only focuses on monitoring symptoms and providing dietary education, but does not address the immediate need to correct potassium levels. Choice D is also incorrect as administering diuretics would exacerbate hypokalemia by increasing potassium loss.

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