Nursing Elites

1. A nurse is preparing a plan of care for a client with DM who has hyperglycemia. The priority nursing diagnosis would be:

• A. High risk for deficient fluid volume
• B. Deficient knowledge: disease process and treatment
• C. Imbalanced nutrition: less than body requirements
• D. Disabled family coping: compromised

Correct answer: A

Rationale: The priority nursing diagnosis for a client with diabetes mellitus (DM) experiencing hyperglycemia would be 'High risk for deficient fluid volume.' Hyperglycemia can lead to osmotic diuresis, causing significant fluid loss and an increased risk of deficient fluid volume. This nursing diagnosis addresses the immediate physiological concern related to fluid balance.\n\nChoice B, 'Deficient knowledge: disease process and treatment,' focuses on the client's understanding of DM, which is important but not the priority when the client is at risk of fluid volume deficit.\n\nChoice C, 'Imbalanced nutrition: less than body requirements,' pertains to inadequate intake of nutrients, which is not the priority concern when fluid volume deficit poses a more immediate threat.\n\nChoice D, 'Disabled family coping: compromised,' addresses a psychosocial aspect and is not the priority over the critical physiological issue of fluid volume deficit in a client with hyperglycemia.

2. Which of the following describes the role of the nurse in advocating for a patient?

• A. The nurse ensures that the patient has all the information needed to make an informed decision about their care.
• B. The nurse advocates for the patient by communicating their needs and preferences to the healthcare team.
• C. The nurse advocates for the patient by ensuring that they receive the care they need and by protecting their rights.
• D. The nurse advocates for the patient by helping them navigate the healthcare system and access necessary resources.

Correct answer: C

Rationale: The correct answer is C. Nurses advocate for patients by ensuring that they receive the necessary care and by protecting their rights. This involves speaking up for patients, ensuring they are treated with respect, and helping them access appropriate healthcare services. Option A, providing information for informed decision-making, is an important aspect of nursing care but not the central role of advocacy. Option B, communicating patients' needs to the healthcare team, is essential but more focused on teamwork and collaboration. Option D, helping patients navigate the healthcare system and access resources, is valuable but not the primary definition of advocacy in nursing.

3. A client with hyperthyroidism is prescribed propranolol. The nurse understands that this medication is used to:

• A. Increase metabolism
• B. Reduce anxiety
• C. Decrease heart rate
• D. Increase blood pressure

Correct answer: C

Rationale: Propranolol is a beta-blocker commonly used in the management of hyperthyroidism. It works by blocking the effects of adrenaline, resulting in a decrease in heart rate and blood pressure. Choice A is incorrect because propranolol does not increase metabolism; instead, it may have a mild inhibitory effect. Choice B is incorrect as propranolol is not primarily used to reduce anxiety, although it may have some anxiolytic effects. Choice D is incorrect as propranolol actually decreases blood pressure by blocking the effects of adrenaline on the heart and blood vessels.

4. The client has hyperparathyroidism. Which of the following dietary instructions should the nurse provide?

• A. Increase calcium intake
• B. Limit phosphorus intake
• C. Increase fluid intake
• D. Limit vitamin D intake

Correct answer: C

Rationale: The correct answer is to 'Increase fluid intake.' This is because increasing fluid intake helps prevent kidney stones, a common complication of hyperparathyroidism. While calcium is involved in the condition, increasing calcium intake is not recommended as it can exacerbate hypercalcemia, which is commonly present in hyperparathyroidism. Limiting phosphorus intake is not directly related to managing hyperparathyroidism. Limiting vitamin D intake is also not typically necessary in managing hyperparathyroidism, as it is usually a calcium and PTH-related issue.

5. A nurse manager is working to improve patient satisfaction on the unit. Which of the following best describes the nurse manager’s role in this process?

• A. The nurse manager should set clear expectations for patient satisfaction, monitor progress, and provide feedback to staff members to continuously improve patient care.
• B. The nurse manager should gather data on patient satisfaction, identify areas for improvement, and implement strategies to enhance the patient experience.
• C. The nurse manager should develop a patient satisfaction improvement plan, set measurable goals, and track progress over time to ensure continuous improvement.
• D. The nurse manager should involve patients and families in the patient satisfaction improvement process, gather feedback, and use it to make improvements to care delivery.

Correct answer: A

Rationale: The correct answer is A. The nurse manager's role in improving patient satisfaction involves setting clear expectations for patient satisfaction, monitoring progress, and providing feedback to staff members to continuously improve patient care. Choice B is incorrect as gathering data and implementing strategies are typically part of quality improvement initiatives but do not solely define the nurse manager's role. Choice C is incorrect because the nurse manager is responsible for setting expectations and monitoring progress rather than developing the improvement plan. Choice D is incorrect as involving patients and families and gathering feedback are important aspects, but the question specifically asks about the nurse manager's role, which primarily involves setting expectations, monitoring progress, and providing feedback to staff.

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