Nursing Elites

1. The nurse determines a need for additional instruction when the patient with newly diagnosed type 1 diabetes says which of the following?

• A. �I can have an occasional alcoholic drink if I include it in my meal plan.�
• B. �I will need a bedtime snack because I take an evening dose of NPH insulin.�
• C. �I can choose any foods, as long as I use enough insulin to cover the calories.�
• D. �I will eat something at meal times to prevent hypoglycemia, even if I am not hungry.�

Correct answer: C

Rationale:

2. When a client is receiving pain medication through a PCA pump, which of the following actions should the nurse take?

• A. Educate the family not to push the button for the client while the client is asleep.
• B. Explain to the client that vital signs will be monitored regularly due to being on a PCA pump.
• C. Instruct the client to push the button only when pain is above a 7 on a scale of 0 to 10.
• D. Adjust the basal rate and decrease the lock-out interval time if the client's pain level is too high.

Correct answer: D

Rationale: When a client is receiving pain medication through a PCA pump, it is essential to adjust the settings if their pain level is not adequately controlled. Increasing the basal rate and shortening the lock-out interval time can help manage the client's pain more effectively. This adjustment should be made by the healthcare provider based on the client's pain assessment and response to the current settings. It is crucial to individualize the PCA pump settings to optimize pain management for each client. Choices A, B, and C are incorrect because educating the family not to push the button, explaining vital sign monitoring, and setting a specific pain level for button pushing are not direct actions the nurse should take to adjust the PCA pump settings for effective pain management.

3. When a client with a terminal diagnosis asks about advance directives, what should the nurse do?

• A. Engage the client and ask why they want to discuss this without their partner present.
• B. Provide information on advance directives and offer brochures.
• C. Advise the client to schedule a discussion with their provider.
• D. Focus on the client's current feelings and postpone planning for a later time.

Correct answer: A

Rationale: Choice A is the correct response as it demonstrates active listening and empathy by engaging the client in a discussion about their concerns regarding advance directives. It also recognizes the importance of involving the client's partner in such discussions, promoting shared decision-making and support. Choices B and C lack the personalized approach needed in this situation and do not address the client's immediate request for information. Choice D is incorrect as it disregards the client's expressed need to discuss advance directives and focuses solely on their current feelings, delaying a crucial conversation.

4. How did the Social Security Act of 1935 impact public health nursing?

• A. Disabled children
• B. Mentally disabled
• C. Older adults
• D. Opioid addicts

Correct answer: A

Rationale: The Social Security Act of 1935 impacted public health nursing by containing provisions for care for disabled children. This helped in improving the health and well-being of this vulnerable population. The Act did not specifically address care for mentally disabled individuals, older adults, or opioid addicts. Therefore, the correct answer is disabled children.

5. Which of the following is an example of an effective conflict resolution strategy?

• A. Ignoring the conflict
• B. Assigning blame to one party
• C. Encouraging open communication
• D. Enforcing strict rules

Correct answer: C

Rationale: Encouraging open communication is an effective conflict resolution strategy because it promotes transparency, understanding, and collaboration among individuals involved in the conflict. By encouraging open communication, parties can express their perspectives, concerns, and needs, leading to the identification of common ground and potential solutions. This approach fosters a positive and constructive environment for resolving conflicts and can help prevent misunderstandings and escalation of issues. Choices A, B, and D are not effective conflict resolution strategies. Ignoring the conflict can lead to unresolved issues, assigning blame can escalate tensions and hinder problem-solving, and enforcing strict rules may not address the underlying causes of the conflict or promote mutual understanding.

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