Nursing Elites

1. A patient is admitted to the emergency department with hypovolemia. Which IV solution should the nurse anticipate administering?

• A. 3% sodium chloride
• B. 10% dextrose in water
• C. 0.45% sodium chloride
• D. Lactated Ringer's solution

Correct answer: D

Rationale: Lactated Ringer's solution is the most suitable IV solution for a patient with hypovolemia. It is a balanced crystalloid solution containing electrolytes such as sodium, chloride, potassium, calcium, and lactate, which closely resemble the body's natural fluids. This solution helps to restore intravascular volume and electrolyte balance in hypovolemic patients. Choice A, 3% sodium chloride, is a hypertonic solution used for specific situations like severe hyponatremia or cerebral edema, not typically for hypovolemia. Choice B, 10% dextrose in water, is a hypertonic solution primarily used for providing calories and free water, not for volume expansion. Choice C, 0.45% sodium chloride, is a hypotonic solution used for conditions like hypernatremia or as maintenance fluid, not for hypovolemia.

2. What is the main objective of palliative care?

• A. To cure the disease
• B. To provide relief from symptoms and improve quality of life
• C. To extend hospital stays
• D. To focus solely on treatment

Correct answer: B

Rationale: The main objective of palliative care is to provide relief from symptoms and improve quality of life. Palliative care focuses on enhancing the quality of life for patients facing serious illnesses by providing relief from symptoms such as pain, stress, and other physical and emotional issues. Choice A is incorrect because palliative care does not aim to cure the disease but rather to manage symptoms. Choice C is incorrect as the goal of palliative care is not to extend hospital stays unnecessarily but to improve the patient's well-being. Choice D is incorrect as palliative care is not solely focused on treatment but takes a holistic approach to care that includes addressing physical, emotional, social, and spiritual needs.

3. Which of the following is expected to be most likely true in the near future?

• A. Quality improvement projects will decline due to cost-cutting measures.
• B. Alternative and complementary approaches will gain acceptance in medical practice.
• C. Care will primarily shift away from the hospital setting.
• D. Increased focus on care transitions will involve nursing.

Correct answer: D

Rationale: In the near future, there will be an increased focus on care transitions involving nursing. This means that nurses will play a crucial role in preparing patients for transitions between different care settings, ensuring continuity and quality of care. Choice A is incorrect because quality improvement projects are essential and are not expected to decline. Choice B is incorrect as alternative and complementary approaches are increasingly being integrated into medical practice. Choice C is incorrect as there is a growing trend towards providing care in community settings and homes, moving away from primarily hospital-based care.

4. Which nursing diagnosis is commonly used among patients affected by fibromyalgia?

• A. Decreased self-care in activities of daily living related to fatigue
• B. Impaired mental functioning related to electrolyte imbalances
• C. Increased vigilance secondary to electrolyte imbalances
• D. At risk for a swallowing disorder related to fibromyalgia

Correct answer: A

Rationale: The correct answer is A: 'Decreased self-care in activities of daily living related to fatigue.' Patients with fibromyalgia commonly experience fatigue, which can lead to decreased ability to perform self-care activities. This nursing diagnosis addresses a direct consequence of fibromyalgia. Choices B, C, and D are incorrect because they do not directly correlate with the common manifestations of fibromyalgia. Impaired mental functioning related to electrolyte imbalances and increased vigilance secondary to electrolyte imbalances are not typical presentations of fibromyalgia. 'At risk for a swallowing disorder related to fibromyalgia' is not a common nursing diagnosis associated with fibromyalgia; swallowing disorders are not a primary symptom of this condition.

5. Select the ethical principles that are paired with their descriptions. Select the one that does not apply.

• A. Justice: Being honest and fair
• B. Beneficence: Doing good
• C. Veracity: Truthfulness
• D. Self-determination: Facilitating patient choices

Correct answer: C

Rationale: The correct answer is C. Veracity is the principle of truthfulness, not treating all patients equally. Choice A is correct as Justice involves being honest and fair. Choice B is correct as Beneficence is about doing good. Choice D is correct as Self-determination is about respecting and facilitating patient choices.

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