Nursing Elites

1. The decades between the 1960s and 1980s brought about many changes in nursing. Which of the following contributed to advances in nursing?

• A. Decreased demand for health care
• B. Development of specialty care disciplines
• C. Gender discrimination
• D. Advances in technology leading to more generalized care

Correct answer: B

Rationale: The correct answer is B because the development of specialty care disciplines, such as intensive care, neurosurgical techniques, and cardiothoracic surgery, played a significant role in advancing nursing during the specified decades. Choice A is incorrect as decreased demand for health care would not drive advances in nursing. Choice C is also incorrect as gender discrimination, while an issue in the past, does not directly relate to the advancements in nursing during this period. Choice D is incorrect because advances in technology usually lead to more specialized care rather than generalized care.

2. A middle adult client tells the nurse, 'I feel so useless now that my children do not need me anymore.' Which of the following responses should the nurse make?

• A. Validate the client's feelings by saying, 'People in middle adulthood often find satisfaction in nurturing and guiding young people.'
• B. Encourage the client to explore the reasons behind feeling useless.
• C. Reassure the client by saying, 'You should be proud that your children are becoming independent.'
• D. Provide information by saying, 'Most people are happy when their children grow up and leave home.'

Correct answer: A

Rationale: The correct response is to validate the client's feelings by acknowledging that individuals in middle adulthood often derive satisfaction from nurturing and guiding young people. This response shows empathy and understanding towards the client's emotions. Choice B is incorrect because it may come across as dismissive of the client's feelings. Choice C is incorrect as it does not address the client's emotional state and could be perceived as minimizing their concerns. Choice D is incorrect as it generalizes feelings and may not be applicable to the client's specific situation.

3. In which order will the nurse take these steps to prepare NPH 20 units and regular insulin 2 units using the same syringe? (Put a comma and a space between each answer choice [A, B, C, D, E]).

• A. Rotate NPH vial, Inject 20 units of air into NPH vial, Withdraw regular insulin, Inject 2 units of air into regular insulin vial, Withdraw 20 units of NPH.
• B. Rotate NPH vial, Inject 20 units of air into NPH vial, Withdraw regular insulin, Inject 2 units of air into regular insulin vial, Withdraw 20 units of NPH.
• C. Rotate NPH vial, Inject 20 units of air into NPH vial, Inject 2 units of air into regular insulin vial, Withdraw regular insulin, Withdraw 20 units of NPH.
• D. Rotate NPH vial, Inject 20 units of air into NPH vial, Withdraw 20 units of NPH, Inject 2 units of air into regular insulin vial, Withdraw regular insulin.

Correct answer: C

Rationale: The correct order to prepare NPH 20 units and regular insulin 2 units using the same syringe is to start by rotating the NPH vial, then injecting 20 units of air into the NPH vial. Next, inject 2 units of air into the regular insulin vial, followed by withdrawing the regular insulin. Finally, withdraw 20 units of NPH. This sequence ensures proper mixing and preparation of the insulin doses. Choices A, B, and D have incorrect sequences that may lead to incorrect dosages or inadequate mixing of the insulins.

4. Selye's stress theory explains that a person stressed for long periods of time will:

• A. Face exhaustion and be more susceptible to illnesses.
• B. Become fatigued and become stronger.
• C. Become more assertive.
• D. Safety needs.

Correct answer: A

Rationale: Selye's stress theory posits that individuals experiencing prolonged stress are likely to face exhaustion and become more susceptible to illnesses. This is because the body's response to chronic stress can lead to physical and psychological depletion, increasing the risk of health problems. Choice B is incorrect as becoming stronger is not a typical outcome of prolonged stress according to Selye's theory. Choice C, becoming more assertive, is not directly related to the physical implications of chronic stress. Choice D, safety needs, is unrelated to Selye's stress theory and does not reflect the expected outcomes of prolonged stress.

5. A nurse is assessing a client who received an IV fluid bolus for dehydration. Which of the following findings should the nurse identify as an indication of fluid volume excess?

• A. Hypotension
• B. Distended neck veins
• C. Slow capillary refill
• D. Weak, thready pulse

Correct answer: B

Rationale: The correct answer is B: 'Distended neck veins.' Distended neck veins are a sign of fluid volume excess, indicating an overload of fluids in the body. This can be caused by excessive fluid administration. Hypotension (choice A) is more commonly associated with fluid volume deficit. Slow capillary refill (choice C) and a weak, thready pulse (choice D) are also signs of decreased fluid volume, not fluid volume excess.

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