Nursing Elites

1. A nurse is preparing a client for surgery. The client has signed the consent form but tells the nurse that she has reconsidered because she is worried about the pain. Which of the following responses by the nurse is appropriate?

• A. If you have the procedure now, you won't have to deal with pain and disability later.
• B. You'll be fine. You'll receive a prescription for pain medication.
• C. Why didn't you discuss your concerns with your provider?
• D. I understand and it's not too late to change your mind.

Correct answer: D

Rationale: The appropriate response acknowledges the client's concern and confirms that they have the right to change their mind.

2. A client is in DKA, secondary to infection. As the condition progresses, which of the following symptoms might the nurse see?

• A. Kussmaul's respirations and a fruity odor on the breath
• B. Shallow respirations and severe abdominal pain
• C. Decreased respirations and increased urine output
• D. Cheyne-Stokes respirations and foul-smelling urine

Correct answer: A

Rationale: In diabetic ketoacidosis (DKA), as the condition progresses, the body tries to compensate for the acidic environment by increasing the respiratory rate, leading to Kussmaul's respirations. The accumulation of ketones in the body causes a fruity odor on the breath. Option A is correct because Kussmaul's respirations and a fruity odor on the breath are classic signs of DKA. Option B is incorrect because shallow respirations are not typically seen in DKA, and severe abdominal pain is more commonly associated with conditions like pancreatitis. Option C is incorrect as decreased respirations are not a typical finding in DKA, and increased urine output is more commonly seen in conditions like diabetes insipidus. Option D is incorrect because Cheyne-Stokes respirations are not characteristic of DKA, and foul-smelling urine is not a prominent symptom in this condition.

3. Select the cranial nerve that is accurately paired with its name.

• A. The fourth cranial nerve: The trochlear nerve
• B. The twelfth cranial nerve: The hypoglossal nerve
• C. The tenth cranial nerve: The olfactory nerve
• D. The thirteenth cranial nerve: The auditory nerve

Correct answer: B

Rationale: The twelfth cranial nerve is the hypoglossal nerve, which controls the muscles of the tongue. The other choices are incorrect because the trochlear nerve is the fourth cranial nerve responsible for eye movement, the olfactory nerve is the first cranial nerve responsible for the sense of smell, and there are only twelve cranial nerves, so there is no thirteenth cranial nerve.

4. Although there is projected to be a small surplus of nurses by 2030, some states will continue to see nursing shortages. Which of the following is the best explanation for this situation?

• A. Healthcare legislation that impacts nursing salaries in some states
• B. Workforce availability
• C. Aging of the baby boomers, resulting in a younger nursing workforce
• D. Population declines

Correct answer: B

Rationale: The best explanation for the continued nursing shortages in some states despite an overall projected surplus by 2030 is workforce availability. This factor directly impacts the number of nurses available in certain regions. Choice A about healthcare legislation affecting nursing salaries does not directly address the availability of nurses. Choice C is incorrect as the aging of the baby boomers would typically imply an older nursing workforce instead of a younger one. Choice D regarding population declines does not necessarily relate to the availability of nurses in specific states.

5. What is a cavity containing pus surrounded by inflamed tissue?

• A. Cellulitis.
• B. An abscess.
• C. Extravasation.
• D. An adhesion.

Correct answer: B

Rationale: An abscess is defined as a cavity containing pus surrounded by inflamed tissue. Cellulitis is a bacterial skin infection causing redness and swelling, not a cavity. Extravasation is the leakage of fluid from a vessel into surrounding tissues, not a cavity. An adhesion is a band of scar-like tissue that binds two parts together, not a cavity containing pus and inflamed tissue.

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