Nursing Elites

1. A nurse is preparing to administer a high dose of morphine to a patient with terminal cancer. What is the nurse's primary consideration before administration?

• A. Ensure the family is aware of the dosage to be administered.
• B. Monitor the patient for respiratory depression.
• C. Administer the morphine in divided doses.
• D. Delay administration until the next assessment.

Correct answer: B

Rationale: The correct answer is B: Monitor the patient for respiratory depression. When administering a high dose of morphine, the nurse's primary consideration should be to monitor the patient for respiratory depression, as morphine can slow down breathing, especially in higher doses. Option A is incorrect because the primary focus should be on the patient's well-being and safety rather than family awareness at this point. Option C is not the best approach as the immediate concern is monitoring the patient closely for any adverse effects. Option D is not advisable as delaying administration without a valid reason can compromise pain management in a terminal cancer patient.

2. A nurse enters a client's room and finds the client pulseless. The client's living will requests no resuscitation be performed, but the provider has not written the prescription. Which of the following actions should the nurse take?

• A. Administer emergency medications without performing CPR
• B. Begin CPR
• C. Call the provider for a do-not-resuscitate (DNR) order
• D. Respect the client's wishes, and do not attempt CPR

Correct answer: B

Rationale: The correct action for the nurse to take in this situation is to begin CPR. In the absence of a written DNR order by the provider, the nurse is ethically and legally obligated to initiate CPR to attempt to save the client's life. Administering emergency medications without CPR (Choice A) may not address the immediate need for life-saving measures. Calling the provider for a DNR order (Choice C) may cause a delay in providing necessary resuscitative measures. Respecting the client's wishes and not attempting CPR (Choice D) goes against the nurse's duty to provide immediate life-saving interventions in the absence of a DNR order.

3. When preparing to give a report during a shift change, what information is most critical to communicate?

• A. Include a full family medical history.
• B. Focus on changes in the patient's condition.
• C. Summarize the patient's treatment plan.
• D. Provide updates on the patient's lab results.

Correct answer: B

Rationale: During a shift change report, the most critical information to communicate is focusing on changes in the patient's condition. This helps ensure that all healthcare providers are aware of any significant developments or deterioration in the patient's health status, allowing for timely and appropriate interventions. Choices A, C, and D are not as crucial during a shift report. While a full family medical history and treatment plan are important aspects of patient care, they are not the primary focus during a shift change report. Providing updates on lab results may be important but may not be as time-sensitive or immediately impactful as changes in the patient's condition.

4. A nurse is caring for a patient postoperatively after a thyroidectomy. Which of the following findings should be reported immediately?

• A. Hoarseness
• B. Difficulty swallowing
• C. Numbness in the fingers
• D. Tingling around the mouth

Correct answer: D

Rationale: Tingling around the mouth should be reported immediately as it may indicate hypocalcemia, a serious complication resulting from accidental removal or damage to the parathyroid glands during thyroidectomy. Hoarseness and difficulty swallowing are common post-thyroidectomy symptoms related to the surgery itself and the manipulation of the vocal cords and nearby structures. Numbness in the fingers is not typically associated with immediate serious complications of a thyroidectomy.

5. Which personality disorder is characterized by disregard for others and manipulative behaviors?

• A. Borderline Personality Disorder
• B. Antisocial Personality Disorder
• C. Histrionic Personality Disorder
• D. Narcissistic Personality Disorder

Correct answer: B

Rationale: Antisocial Personality Disorder is the correct answer. This disorder is characterized by a pervasive pattern of disregard for and violation of the rights of others. Individuals with this disorder often display behaviors such as manipulation, exploitation, and a lack of empathy. Choice A, Borderline Personality Disorder, is characterized by unstable moods, behavior, and relationships. Choice C, Histrionic Personality Disorder, is characterized by attention-seeking behavior and excessive emotions. Choice D, Narcissistic Personality Disorder, is characterized by a grandiose sense of self-importance, a need for admiration, and a lack of empathy for others.

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