Nursing Elites

1. The nurse is caring for a client with diabetes insipidus. Which of the following laboratory findings should the nurse monitor?

• A. Serum sodium
• B. Serum potassium
• C. Serum calcium
• D. Serum magnesium

Correct answer: A

Rationale: In diabetes insipidus, there is excessive excretion of water leading to dehydration. Monitoring serum sodium levels is crucial because these clients often experience hypernatremia (elevated serum sodium levels) due to the loss of relatively more water than sodium, resulting in a sodium concentration imbalance. While monitoring serum potassium, calcium, and magnesium levels is also important in various conditions, they are not the primary focus in diabetes insipidus.

2. As a nurse manager rounds on the unit, he speaks with staff, patients, and family members. Later in the day, he is in a meeting with administration. During the conversations, he considers how these interactions impact the care provided to patients on the unit. Which of the following interpersonal activities best describes this manager’s actions?

• A. Networking
• B. Employee development
• C. Coaching
• D. Monitoring

Correct answer: A

Rationale: The correct answer is 'Networking.' Networking involves building relationships and connecting with staff, patients, and family members to establish a supportive network. In this scenario, the nurse manager is engaging in networking by interacting with various individuals to understand how these interactions influence patient care. 'Employee development' involves activities aimed at enhancing employees' skills and knowledge. 'Coaching' focuses on guiding individuals to improve performance, while 'Monitoring' involves overseeing and supervising activities to ensure compliance and quality.

3. Which of the following statements should be included in the teaching to a client about a do-not-resuscitate order (DNR)?

• A. When a heart ceases to beat, the client is pronounced clinically dead.
• B. Physicians are required to write DNR orders.
• C. A DNR order can be written after discussion with the client and family.
• D. A court decision is needed for a DNR.

Correct answer: C

Rationale: The correct statement to include in teaching a client about a do-not-resuscitate (DNR) order is that it can be written after discussion with the client and family. This involves ensuring that the client and their family understand the implications and make an informed decision. Choice A is incorrect as pronouncing clinical death is not directly related to discussing a DNR order. Choice B is incorrect as while physicians typically write DNR orders, it is not a strict requirement. Choice D is incorrect as a court decision is not typically required for a DNR order; it is a decision made by the client with input from healthcare providers and family members.

4. Scientific management and human relations-based approach are two major theoretical management schools of thought. Which of the following best describes the scientific model of management?

• A. A nurse manager considers methods of motivating the staff to do their assigned tasks.
• B. A nurse manager commends staff for the work they do, reminding them of the importance of their work and the lives they have saved.
• C. A nurse manager analyzes the role of each staff member on the unit to determine ways to increase efficiency.
• D. A conflict between two staff nurses has impacted an entire unit. The unit manager meets with the nurses and entire staff to promote mutual understanding.

Correct answer: C

Rationale: The correct answer is C because scientific management focuses on improving efficiency through the analysis of tasks and work processes. Choice A is more aligned with a human relations-based approach, which emphasizes motivation and relationships. Choice B reflects recognition and morale boosting, which is also characteristic of the human relations approach. Choice D involves conflict resolution and promoting mutual understanding, which is related to the human relations approach rather than scientific management.

5. The healthcare provider is caring for a client with pheochromocytoma. Which of the following interventions should the healthcare provider implement?

• A. Administer beta-blockers to control blood pressure
• B. Encourage a high-sodium diet
• C. Monitor for signs of hyperglycemia
• D. Restrict fluid intake to prevent edema

Correct answer: A

Rationale: The correct intervention for a client with pheochromocytoma is to administer beta-blockers to control blood pressure. Pheochromocytoma is a catecholamine-secreting tumor that can cause severe hypertension. Beta-blockers are used to block the effects of catecholamines and help control blood pressure in these clients. Encouraging a high-sodium diet (Choice B) would not be appropriate as it can worsen hypertension. Monitoring for signs of hyperglycemia (Choice C) is not directly related to managing pheochromocytoma. Restricting fluid intake (Choice D) may lead to dehydration and is not a recommended intervention for this condition.

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