Nursing Elites

1. A nurse manager is planning to promote client advocacy among staff in a medical unit. Which of the following actions should the nurse take?

• A. Encourage staff to implement the principle of paternalism when a client is having difficulty making a choice
• B. Tell staff to explain procedures to clients before obtaining informed consent
• C. Instruct unit staff to share personal experiences to help clients make decisions
• D. Develop a system for staff members to report safety concerns in the client care environment

Correct answer: D

Rationale: The correct answer is D. Developing a system for staff members to report safety concerns in the client care environment is crucial to promoting client advocacy and ensuring client safety. This action empowers staff to identify and address potential safety issues, ultimately enhancing the quality of care provided. Choices A, B, and C are incorrect. Choice A suggests implementing paternalism, which involves making decisions for clients without their input, contradicting the principles of client advocacy. Choice B focuses on informed consent procedures, which are important but do not directly relate to promoting client advocacy among staff. Choice C, sharing personal experiences, may not always align with professional boundaries and can potentially bias clients' decision-making processes.

2. A nurse is caring for a client who has acute pancreatitis. Which of the following laboratory results should the nurse expect to be elevated?

• A. Serum creatinine.
• B. Amylase.
• C. Hemoglobin.
• D. Blood glucose.

Correct answer: B

Rationale: The correct answer is B: Amylase. Amylase is typically elevated in clients with acute pancreatitis due to inflammation of the pancreas. Elevated serum creatinine levels are more indicative of kidney dysfunction rather than pancreatitis. Hemoglobin levels are not directly related to pancreatitis. While blood glucose levels can be affected by pancreatitis, they are not typically the primary laboratory result expected to be elevated in this condition.

3. A nurse is caring for a client who is receiving oxytocin to augment labor. The client's contractions are occurring every 2 minutes with a duration of 90 seconds. Which of the following actions should the nurse take?

• A. Increase the oxytocin infusion.
• B. Maintain the oxytocin infusion.
• C. Discontinue the oxytocin infusion.
• D. Provide reassurance to the client.

Correct answer: C

Rationale: The correct action for the nurse to take in this situation is to discontinue the oxytocin infusion. With contractions occurring every 2 minutes and lasting 90 seconds, this pattern indicates hyperstimulation, which can be harmful to the fetus. Discontinuing the oxytocin infusion is essential to prevent further harm. Increasing the oxytocin infusion would exacerbate the situation, maintaining it would continue the risk, and providing reassurance to the client, although important, does not address the need for immediate action to ensure the safety of the fetus.

4. A nurse is assessing a client who has chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse expect?

• A. Increased oxygen saturation with exercise.
• B. Pursed-lip breathing with exertion.
• C. Productive cough with clear sputum.
• D. Clubbing of the fingers.

Correct answer: C

Rationale: The correct answer is C: 'Productive cough with clear sputum.' Clients with COPD often have a chronic productive cough with thick, often purulent sputum. This sputum can be white, yellow, green, or clear. Choices A, B, and D are incorrect. Oxygen saturation may decrease with exertion in COPD due to impaired gas exchange. Pursed-lip breathing is used to control dyspnea, not directly related to increased saturation with exercise. Clubbing of the fingers is typically seen in conditions such as cyanotic heart disease or lung cancer.

5. What is the best intervention for a patient with dehydration?

• A. Administer IV fluids
• B. Provide oral fluids
• C. Encourage fluid intake
• D. Administer electrolytes

Correct answer: A

Rationale: Administering IV fluids is the best intervention for a patient with dehydration because it is the fastest and most effective way to rehydrate the body. IV fluids can quickly restore fluid volume and electrolyte balance in severe cases of dehydration. Providing oral fluids or encouraging fluid intake may not be sufficient for patients with moderate to severe dehydration, as they may have impaired gastrointestinal absorption. While electrolytes are essential for rehydration, administering them alone without fluid replacement may not address the primary issue of fluid loss in dehydration.

Similar Questions