Nursing Elites

1. In reviewing the assessment data of a client suspected of having diabetes insipidus, the nurse expects which of the following after a water deprivation test?

• A. Increased edema and weight gain
• B. Unchanged urine specific gravity
• C. Rapid protein excretion
• D. Decreased blood potassium

Correct answer: B

Rationale: After a water deprivation test in a client suspected of having diabetes insipidus, the nurse would expect the urine specific gravity to remain unchanged. This occurs because in diabetes insipidus, the kidneys are unable to concentrate urine, leading to a low urine specific gravity even after water deprivation. Choices A, C, and D are incorrect. Increased edema and weight gain are not typical findings in diabetes insipidus. Rapid protein excretion is not directly related to the condition, and decreased blood potassium is not a common outcome of a water deprivation test for diabetes insipidus.

2. A client with rheumatoid arthritis is receiving methotrexate (Rheumatrex). The nurse should monitor the client for which of the following adverse effects?

• A. Leukopenia
• B. Hyperglycemia
• C. Hypertension
• D. Hypokalemia

Correct answer: A

Rationale: The correct answer is A: Leukopenia. Methotrexate, used in the treatment of rheumatoid arthritis, can lead to bone marrow suppression, resulting in leukopenia. This condition increases the risk of infections due to decreased white blood cell count. Choices B, C, and D are incorrect because methotrexate is not known to cause hyperglycemia, hypertension, or hypokalemia as its primary adverse effects.

3. The occupational health nurse is completing a yearly self-evaluation. Which activity should the nurse document as an example of proficient performance criteria in professionalism?

• A. Contributes money to a professional society or organization
• B. Maintains chairmanship of the hospital nursing council
• C. Documents the nursing process in care management
• D. Develops policy initiatives that impact occupational health and safety

Correct answer: B

Rationale: Maintaining chairmanship of the hospital nursing council demonstrates leadership and professionalism. This role involves overseeing and leading nursing activities at the hospital, showcasing a high level of responsibility and professionalism. Choices A, C, and D do not directly relate to demonstrating professionalism. Contributing money to a professional society, documenting the nursing process, or developing policy initiatives, while valuable activities, do not directly reflect the same level of leadership and professionalism as maintaining chairmanship.

4. Statistics of illnesses are termed as:

• A. Vital statistics
• B. Morbidity
• C. Statistics
• D. Mortality

Correct answer: B

Rationale: The correct answer is B: 'Morbidity.' Morbidity specifically refers to the statistics of illnesses, encompassing the incidence, prevalence, and duration of disease within a population. Choice A, 'Vital statistics,' typically refers to data on births, deaths, marriages, and divorces. Choice C, 'Statistics,' is a broad term encompassing the collection, analysis, interpretation, and presentation of numerical data. Choice D, 'Mortality,' specifically refers to the state of being subject to death or the number of deaths in a given population.

5. The nurse is caring for a client on mechanical ventilation. When performing endotracheal suctioning, the nurse will avoid hypoxia by

• A. Inserting a fenestrated catheter with a whistle tip without suction
• B. Completing the suction pass in 30 seconds with a pressure of 150 mm Hg
• C. Hyperoxygenating with 100% O2 for 1 to 2 minutes before and after each suction pass
• D. Minimizing the suction pass to 60 seconds while slowly rotating the lubricated catheter

Correct answer: C

Rationale: Hyperoxygenating the client before and after suctioning helps prevent hypoxia by ensuring adequate oxygen levels during the procedure, which briefly interrupts the client's normal breathing pattern. Choice A is incorrect because inserting a fenestrated catheter with a whistle tip without suction would not prevent hypoxia. Choice B is incorrect as completing the suction pass in 30 seconds with a pressure of 150 mm Hg may lead to hypoxia. Choice D is incorrect as minimizing the suction pass to 60 seconds may not provide enough time for effective suctioning and could lead to hypoxia.

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