Nursing Elites

1. An advance directive known as a durable power of attorney involves appointing another person called a(n) _____ to act as the decision maker in the event of the patient's incapacitation.

• A. witness
• B. primary caregiver
• C. health care agent
• D. state proxy

Correct answer: C

Rationale: The correct answer is 'health care agent.' A health care agent is appointed through a durable power of attorney to make medical decisions on behalf of a patient who becomes incapacitated. The term 'witness' (choice A) is incorrect because a witness only observes the signing of the directive and does not make decisions. 'Primary caregiver' (choice B) is also incorrect as they may provide care but are not necessarily legally empowered to make decisions. 'State proxy' (choice D) is not commonly used in the context of advance directives or health care decision making, making it an incorrect choice.

2. Among people who are ill, significant weight loss may be masked by?

• A. dehydration
• B. a large tumor
• C. drug therapy
• D. fluid retention

Correct answer: D

Rationale: Fluid retention can mask weight loss in ill individuals as the retained fluid adds to body weight, making it difficult to detect true fat or muscle loss. Dehydration (Choice A) would actually lead to weight loss rather than masking it. While a large tumor (Choice B) could contribute to weight loss, it would not mask the weight loss itself. Drug therapy (Choice C) may cause side effects, including weight changes, but it is unlikely to mask significant weight loss in the same way that fluid retention does.

3. Considering the statement that communication is most effective when barriers are first removed, which of the following is recognized as an inhibiting factor in communication?

• A. Avoidance of universally accepted abbreviations
• B. Usage of incorrect grammar
• C. Poor handwriting
• D. Advanced age of the client

Correct answer: D

Rationale: The correct answer is 'D: Advanced age of the client.' Age can be a significant obstacle in communication due to factors such as hearing loss, cognitive decline, or memory issues, which all can hamper effective communication. Choices A, B, and C, while they may present challenges in communication, are not directly related to age and its influence on communication, making them incorrect. The issues presented by not using universally accepted abbreviations, incorrect grammar, and poor handwriting can be resolved through clarification, education, or the use of alternative communication methods, unlike the difficulties that can arise from advanced age.

4. A nurse is caring for a client who is lactose intolerant. Which of the following clinical manifestations should the nurse assess?

• A. Fever
• B. Blood in stools
• C. Cramping
• D. Steatorrhea

Correct answer: C

Rationale: The correct answer is C: Cramping. Cramping is a common clinical manifestation of lactose intolerance due to the inability to digest lactose properly. Fever (choice A) is not typically associated with lactose intolerance. Blood in stools (choice B) is more indicative of other gastrointestinal issues like inflammatory bowel disease. Steatorrhea (choice D) is the presence of excess fat in the stool and is not a typical symptom of lactose intolerance.

5. Substance abuse is different from substance dependence in that, substance dependence:

• A. includes characteristics of adverse consequences and repeated use
• B. requires long term treatment in a hospital based program
• C. produces less severe symptoms than that of abuse
• D. includes characteristics of tolerance and withdrawal

Correct answer: D

Rationale: Understanding the underlying pathology and therapeutic techniques ensures that nursing care is not only reactive but also preventative, reducing the risk of complications.

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