Nursing Elites

1. Although there is projected to be a small surplus of nurses by 2030, some states will continue to see nursing shortages. Which of the following is the best explanation for this situation?

• A. Healthcare legislation that impacts nursing salaries in some states
• B. Workforce availability
• C. Aging of the baby boomers, resulting in a younger nursing workforce
• D. Population declines

Correct answer: B

Rationale: The best explanation for the continued nursing shortages in some states despite an overall projected surplus by 2030 is workforce availability. This factor directly impacts the number of nurses available in certain regions. Choice A about healthcare legislation affecting nursing salaries does not directly address the availability of nurses. Choice C is incorrect as the aging of the baby boomers would typically imply an older nursing workforce instead of a younger one. Choice D regarding population declines does not necessarily relate to the availability of nurses in specific states.

2. 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.

3. A charge nurse is making staff assignments on a medical-surgical unit. Which of the following tasks should the nurse plan to delegate to an assistive personnel?

• A. Measuring oxygen saturation for a client who has dyspnea
• B. Inserting a rectal suppository for a client who is vomiting
• C. Performing nasal hygiene for a client who has an NG tube
• D. Pouching a client's ostomy bag for a new colostomy

Correct answer: D

Rationale: Pouching a new colostomy is a task that can be safely and appropriately delegated to an assistive personnel as it falls within their scope of practice. Measuring oxygen saturation (Choice A) requires a higher level of training and assessment, making it unsuitable for delegation. Inserting a rectal suppository (Choice B) and performing nasal hygiene (Choice C) involve invasive procedures that are typically performed by licensed nursing staff due to the associated risks and complexities, making them inappropriate for delegation to assistive personnel.

4. A nurse is preparing a client for surgery. The client has signed the consent form but tells the nurse that she has reconsidered because she is worried about the pain. Which of the following responses by the nurse is appropriate?

• A. If you have the procedure now, you won't have to deal with pain and disability later.
• B. You'll be fine. You'll receive a prescription for pain medication.
• C. Why didn't you discuss your concerns with your provider?
• D. I understand and it's not too late to change your mind.

Correct answer: D

Rationale: The appropriate response acknowledges the client's concern and confirms that they have the right to change their mind.

5. Jansen is receiving metformin (Glucophage). What will be the best plan of the nurse with regard to patient education with this drug? Select one that does not apply.

• A. It stimulates the pancreas to produce more insulin.
• B. It must be taken after meals.
• C. It decreases sugar production in the liver.
• D. It inhibits absorption of carbohydrates.

Correct answer: A

Rationale: The correct choice that does not apply is A. Metformin does not stimulate the pancreas to produce more insulin; instead, it works by decreasing sugar production in the liver, inhibiting carbohydrate absorption, and reducing insulin resistance. It is recommended to take metformin with meals to reduce gastrointestinal side effects. Option B is incorrect as metformin is usually taken with meals. Option D is also incorrect as metformin does not inhibit the absorption of carbohydrates.

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