Nursing Elites

1. What is the term for a state of disequilibrium wherein a person cannot readily solve a problem or situation using their usual coping mechanisms?

• A. Crisis
• B. Mental health
• C. Mental illness
• D. Stress

Correct answer: A

Rationale: In psychological terms, a 'Crisis' refers to a state of disequilibrium wherein a person cannot readily solve a problem or situation even by using his usual coping mechanisms. This is different from 'Mental Illness' (Choice C) which is a more general term for a wide range of mental health conditions that affect mood, thinking and behavior. 'Mental Health' (Choice B) is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community. Finally, 'Stress' (Choice D) is a state of mental or emotional strain or tension resulting from adverse or demanding circumstances, but it does not necessarily disrupt equilibrium to the extent that usual coping mechanisms are ineffective, unlike 'Crisis'.

2. A healthcare professional is reviewing the lab results of a client who has bulimia nervosa. The professional should notify the provider of which of the following results?

• A. White Blood Cells 5,200/mm³
• B. Hemoglobin 14 g/dL
• C. Magnesium 1.6 mg/dL
• D. Potassium 3.2 mEq/L

Correct answer: D

Rationale: A potassium level of 3.2 mEq/L is below normal and requires provider notification, especially in clients with bulimia nervosa who are at risk of electrolyte imbalances. Low potassium levels can lead to serious complications like cardiac arrhythmias. The other options are within or close to the normal range and would not be a priority for notification.

3. A client who practices Islam and is currently observing dietary restrictions for the month of Ramadan. Which of the following interventions should the nurse include in the plan of care?

• A. Remove pork products from the dietary plan
• B. Facilitate fasting during daylight hours
• C. Serve meat and dairy items together
• D. Provide a low-carb diet on Fridays

Correct answer: B

Rationale: During Ramadan, individuals fast from dawn to sunset. Facilitating fasting during daylight hours respects the dietary practices of clients observing Ramadan. Choice A is incorrect as the dietary restriction during Ramadan involves abstaining from all food and drink during daylight hours, not just beef products. Choice C is incorrect as Muslims generally do not consume meat and dairy together due to religious dietary laws. Choice D is incorrect as providing a low-carb diet on Fridays does not specifically align with the dietary restrictions observed during Ramadan.

4. Which dietary recommendation is most appropriate for a patient with gout?

• A. Increase protein intake
• B. Reduce carbohydrate intake
• C. Avoid purine-rich foods
• D. Increase calcium intake

Correct answer: C

Rationale: The most appropriate dietary recommendation for a patient with gout is to avoid purine-rich foods. Purine-rich foods such as red meat and shellfish can lead to increased uric acid levels in the body, triggering gout flare-ups. Increasing protein intake (Choice A) is not recommended as some high-protein foods are also high in purines. Reducing carbohydrate intake (Choice B) and increasing calcium intake (Choice D) are not directly related to managing gout symptoms.

5. You are taking care of critically ill client and the doctor in charge calls to order a DNR (do not resuscitate) for the client. Which of the following is the appropriate action when getting DNR order over the phone?

• A. Have the registered nurse, family spokesperson, nurse supervisor and doctor sign
• B. Have 2 nurse validate the phone order, both nurses sign the order and the doctor should sign his order within 24
• C. Have the registered nurse, family and doctor sign the order
• D. Have 1 nurse take the order and sign it and have the doctor sign it within 24 hours

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

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