Nursing Elites

1. Select the stage of viral hepatitis that is accurately paired with its characteristic(s).

• A. The prodromal stage: Jaundice begins
• B. The icteric stage: Flu-like symptoms occur
• C. The pre-icteric stage: Elevated urine bilirubin levels
• D. The post-icteric stage: Jaundice and dark urine occur

Correct answer: D

Rationale: The post-icteric stage of viral hepatitis is accurately described as the stage where jaundice and dark urine occur due to the accumulation of bilirubin. The resolution of jaundice and normalization of urine color are seen in this stage. Choices A, B, and C are incorrect. In the prodromal stage, symptoms like fatigue and malaise appear before jaundice. The icteric stage is characterized by jaundice, not flu-like symptoms. The pre-icteric stage does not typically involve elevated urine bilirubin levels, as this occurs after the icteric stage.

2. Rotating injection sites when administering insulin prevents which of the following complications?

• A. Insulin edema
• B. Insulin lipodystrophy
• C. Insulin resistance
• D. Systemic allergic reactions

Correct answer: B

Rationale: Rotating injection sites when administering insulin helps prevent insulin lipodystrophy, which is the abnormal distribution of fat at injection sites. Insulin edema (choice A) is not prevented by rotating injection sites; it is characterized by swelling at the site of insulin injection due to increased capillary permeability. Insulin resistance (choice C) is a condition where the body's cells become less responsive to insulin, and rotating injection sites does not directly prevent this. Systemic allergic reactions (choice D) are not specifically prevented by rotating injection sites; they are related to an allergic response to insulin.

3. Which patient is exercising their right to autonomy in the context of patient rights?

• A. An 86-year-old female who remains independent in terms of the activities of daily living.
• B. An unemancipated 16-year-old who chooses to not have an intravenous line.
• C. A 32-year-old who does not need the help of the nurse to bathe and groom themselves.
• D. A 99-year-old who wants CPR despite the fact that the nurse and doctor do not think that it would be successful.

Correct answer: D

Rationale: The correct answer is D. A 99-year-old exercising their right to autonomy in the context of patient rights by choosing CPR. Autonomy in healthcare refers to the patient's right to make their own decisions about their care, even if healthcare providers may disagree. In this scenario, the 99-year-old patient is exercising autonomy by making an informed choice about their medical treatment, despite healthcare professionals having a different opinion. Choices A, B, and C do not directly demonstrate the exercise of autonomy in decision-making regarding medical treatment, making them incorrect.

4. Which of the following nursing interventions should be taken for a client who complains of nausea and vomits one hour after taking his glyburide (DiaBeta)?

• A. Administer glyburide again
• B. Administer subcutaneous insulin and monitor blood glucose
• C. Monitor blood glucose closely, and look for signs of hypoglycemia
• D. Monitor blood glucose and assess for signs of hyperglycemia

Correct answer: C

Rationale: After a client complains of nausea and vomits one hour after taking glyburide, the priority nursing intervention should be to monitor blood glucose closely and look for signs of hypoglycemia. Vomiting could indicate that the glyburide was not properly absorbed, potentially leading to hypoglycemia. Administering glyburide again (Choice A) could worsen hypoglycemia. Administering subcutaneous insulin (Choice B) is not appropriate without assessing the blood glucose first. Monitoring for signs of hyperglycemia (Choice D) is not the immediate concern in this situation.

5. A client with a tumor refuses surgery, but the client's partner wants it. Which is the deciding factor in determining if the surgery will be done?

• A. Whether the partner is the client's durable power of attorney for healthcare
• B. Whether the client understands the risk of refusing the procedure
• C. Whether the client's refusal is based on religious belief
• D. Whether the facility's ethical committee reaches a consensus on the case

Correct answer: B

Rationale: The correct answer is B because the client's understanding of the risks involved in refusing the surgery is crucial in determining the course of action. In this scenario, the client's autonomy and decision-making capacity take precedence. Choice A is not directly relevant to the decision-making process regarding surgery. Choice C, religious beliefs, may influence the decision but should not be the determining factor in this case. Choice D involving the facility's ethical committee is not typically involved in individual patient care decisions.

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