Nursing Elites

1. A nurse is reviewing laboratory results and notes that a client's serum sodium level is 150 mEq/L. The nurse reports the serum sodium level to the physician, and the physician prescribes dietary instructions based on the sodium level. Which food item should the nurse instruct the client to avoid?

• A. Peas
• B. Cauliflower
• C. Low-fat yogurt
• D. Processed oat cereals

Correct answer: D

Rationale: The correct answer is processed oat cereals. Processed oat cereals are often high in sodium content, which should be avoided in cases of hypernatremia. Peas, cauliflower, and low-fat yogurt are generally low in sodium and are not typically contraindicated in hypernatremia. Therefore, choices A, B, and C are incorrect.

2. A nurse is caring for a client who is unconscious and whose partner is their health care surrogate. The partner wishes to discontinue the client's feeding tube, but another family member tells the nurse that they want the client to continue receiving treatment. Which of the following responses should the nurse make?

• A. You should contact the provider about your wishes for your family member.
• B. We'll need to have the nursing supervisor review the client's advance directives.
• C. You should speak with the facility's ethics committee about your concerns.
• D. As the health care surrogate, the client's partner can make this decision.

Correct answer: D

Rationale: The correct response is D because the health care surrogate, as designated by the client, has the legal authority to make healthcare decisions on behalf of the client when they are unable to do so. This authority includes decisions about treatment continuation or withdrawal. Option A is incorrect as the family member's wishes do not override the legal authority of the health care surrogate. Option B is not the most appropriate action in this situation as the advance directives are already clear by the designation of a health care surrogate. Option C is not necessary at this stage since the health care surrogate can make the decision without involving the ethics committee.

3. Who is credited with the stages of cognitive development?

• A. Erikson
• B. Piaget
• C. Freud
• D. Lister

Correct answer: B

Rationale: Piaget is indeed credited with the stages of cognitive development. Jean Piaget, a renowned psychologist, proposed a theory of cognitive development that outlines distinct stages through which children develop intellectually. Erikson, Freud, and Lister are not associated with the stages of cognitive development. Erikson is known for his psychosocial stages, Freud for psychosexual stages, and Lister for contributions to the field of medicine.

4. Which preventive measure can be employed to decrease the risk of compartment syndrome?

• A. The administration of a potassium-sparing diuretic for heart failure
• B. A bivalve cast for a skeletal fracture
• C. A cerebral diuretic to decrease intracranial pressure after a head injury
• D. A chest tube to restore normal intrathoracic pressure after a pneumothorax

Correct answer: B

Rationale: The correct answer is B. A bivalve cast can help decrease the risk of compartment syndrome by providing space for swelling, thus preventing the build-up of pressure within the muscles. Choices A, C, and D are incorrect because they are not directly related to preventing compartment syndrome. Choice A is more focused on managing heart failure, choice C on reducing intracranial pressure, and choice D on restoring intrathoracic pressure after a pneumothorax, which are not relevant to preventing compartment syndrome.

5. A nurse is preparing to delegate bathing and turning of a newly admitted client who has end-stage cancer to an experienced assistive personnel (AP). Which of the following assessments should the nurse make before delegating care?

• A. Is the client's family present so the AP can show them how to turn the client?
• B. Has data been collected about specific client needs related to turning?
• C. Does the AP have time to change the client's central IV line dressing after turning her?
• D. Has the AP checked the client's pain level prior to turning her?

Correct answer: B

Rationale: Before delegating the task of bathing and turning a client with end-stage cancer to an experienced assistive personnel (AP), the nurse must assess specific client needs related to turning. This assessment ensures that the delegated care is tailored to the client's individual requirements, promoting safe and effective care. Option A is incorrect because the presence of the client's family is not directly related to assessing the client's specific needs for turning. Option C is incorrect as it refers to a different task (changing the central IV line dressing) and is not directly related to the turning assessment. Option D is incorrect as checking the client's pain level, although important, is not directly related to the specific needs related to turning the client.

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