Nursing Elites

1. The mentally ill person responds positively to the nurse who is warm and caring. This is a demonstration of the nurse’s role as:

• A. counselor
• B. mother surrogate
• C. therapist
• D. socializing agent

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

2. When assessing older adult clients for malnutrition at an adult day care center, which risk factors should the nurse consider?

• A. Dental problems
• B. Depression
• C. Both A and B
• D. Ability to prepare meals

Correct answer: C

Rationale: The correct answer is C: Both A and B. Dental problems and depression are both significant risk factors for malnutrition in older adults. Dental problems can lead to difficulty in chewing and swallowing, resulting in reduced food intake. On the other hand, depression can cause changes in appetite and decreased interest in eating, which can also contribute to malnutrition. Although the ability to prepare meals is important, it is not specifically identified as a risk factor for malnutrition within the context of this question. Therefore, choices A and B are the most appropriate answers.

3. How is the equalization of solute concentration of intracellular fluids (ICFs) and extracellular fluids (ECFs accomplished?

• A. Semipermeable membranes.
• B. Hydration.
• C. Osmotic pressure.
• D. Perspiration.

Correct answer: C

Rationale: The correct answer is C, osmotic pressure. Osmotic pressure within the body equalizes the solute concentration of ICFs and ECFs by shifting small amounts of water in the direction of higher concentration solute. Semipermeable membranes separate one fluid compartment from another and do not directly equalize solute concentrations. Hydration and perspiration are important elements of fluid balance but do not directly achieve the equalization of solute concentrations between ICFs and ECFs, which is primarily regulated by osmotic pressure.

4. Which of the following nursing interventions is appropriate after a total thyroidectomy?

• A. Place pillows under your patient’s shoulders.
• B. Raise the knee-gatch to 30 degrees
• C. Keep you patient in a high-fowler’s position.
• D. Support the patient’s head and neck with pillows and sandbags.

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.

5. During the first 24 hours after the thermal injury, you should assess Sergio for:

• A. hypokalemia and hypernatremia
• B. hypokalemia and hyponatremia
• C. hyperkalemia and hyponatremia
• D. hyperkalemia and hypernatremia

Correct answer: D

Rationale: During the initial phase after a thermal injury, the major concern is the release of potassium due to cell damage, leading to hyperkalemia. Hypernatremia is not typically a primary concern in the immediate post-injury phase. Hyponatremia is less likely to occur initially after a burn injury. Therefore, the correct assessment for Sergio during the first 24 hours after the thermal injury would be hyperkalemia and hypernatremia.

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