Nursing Elites

1. Nurse managers need several qualities to be effective. A nurse manager is working hard to fully understand how patient outcomes are measured on the unit and how budget changes could impact patient outcomes. Which of the following qualities does this best describe?

• A. Leadership
• B. Business sense
• C. Clinical expertise
• D. Financial management

Correct answer: B

Rationale: The correct answer is 'Business sense.' Nurse managers need to understand how financial decisions impact patient outcomes, which requires a strong understanding of business principles. Leadership (choice A) is important but doesn't specifically address understanding financial and outcome-based impacts. Clinical expertise (choice C) is essential for patient care but doesn't directly relate to understanding budget changes and their impact. Financial management (choice D) is more about managing finances directly rather than understanding the broader implications of budget changes on patient outcomes.

2. In a client with hypoparathyroidism, the nurse should expect which laboratory result?

• A. Increased calcium levels
• B. Decreased phosphorus levels
• C. Increased phosphorus levels
• D. Increased potassium levels

Correct answer: C

Rationale: In hypoparathyroidism, there is a deficiency of parathyroid hormone, leading to decreased calcium levels and increased phosphorus levels. Therefore, the correct answer is 'Increased phosphorus levels' (Choice C). Choice A, 'Increased calcium levels,' is incorrect because hypoparathyroidism is associated with low calcium levels. Choice B, 'Decreased phosphorus levels,' is incorrect as phosphorus levels are typically elevated in hypoparathyroidism. Choice D, 'Increased potassium levels,' is not directly related to hypoparathyroidism and is not an expected laboratory result in this condition.

3. A male client with primary diabetes insipidus is ready for discharge on desmopressin (DDAVP). Which instruction should nurse Lina provide?

• A. Administer desmopressin while the suspension is cold.
• B. Your condition isn't chronic, so you won't need to wear a medical identification bracelet.
• C. You may not be able to use desmopressin nasally if you have nasal discharge or blockage.
• D. You won't need to monitor your fluid intake and output after you start taking desmopressin.

Correct answer: C

Rationale: The correct instruction is choice C: 'You may not be able to use desmopressin nasally if you have nasal discharge or blockage.' Nasal congestion or blockage can interfere with the absorption of nasally administered desmopressin. Choices A, B, and D are incorrect. Choice A is unnecessary as the temperature of the suspension does not impact desmopressin administration. Choice B is incorrect as wearing a medical identification bracelet is essential for individuals with diabetes insipidus to alert healthcare providers in case of emergencies. Choice D is incorrect as monitoring fluid intake and output is crucial when taking desmopressin to ensure proper hydration and medication effectiveness.

4. A nurse is assigned to care for a group of clients. On reviewing the clients' medical records, the nurse determines that which client is at risk for deficient fluid volume?

• A. A client with a colostomy
• B. A client with congestive heart failure
• C. A client with decreased kidney function
• D. A client receiving frequent wound irrigations

Correct answer: A

Rationale: The correct answer is A. Clients with a colostomy are at risk for deficient fluid volume due to the loss of fluid through the colostomy. In colostomy, there can be increased fluid loss through the stoma, which may lead to dehydration and electrolyte imbalances. Choices B, C, and D do not directly relate to the risk for deficient fluid volume. Clients with congestive heart failure are more prone to fluid overload rather than deficient volume. Clients with decreased kidney function are at risk for fluid retention, not deficient volume. Clients receiving frequent wound irrigations may be at risk for infection, but this does not directly indicate deficient fluid volume.

5. What is the nurse's responsibility when dealing with an impaired colleague?

• A. The nurse should report the colleague to a supervisor and follow the institution's policy for addressing impaired practice.
• B. The nurse should confront the colleague directly and offer support to seek help for the impairment.
• C. Nonmaleficence
• D. The nurse should ignore the colleague's behavior and focus on their own responsibilities.

Correct answer: A

Rationale: When a nurse encounters an impaired colleague, the appropriate action is to report the behavior to a supervisor and follow the institution's policy for addressing impaired practice. This ensures patient safety and upholds professional standards. Choice B is incorrect because confronting the colleague directly may not be appropriate or effective in addressing the issue, and the colleague may need more structured assistance. Choice C is a principle of ethical practice but does not directly address the specific situation of dealing with an impaired colleague. Choice D is incorrect because ignoring the colleague's behavior could potentially compromise patient safety and is not in line with professional responsibility.

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