Nursing Elites

1. The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following clinical manifestations should the nurse expect?

• A. Hypernatremia
• B. Hypotension
• C. Decreased urine output
• D. Polyuria

Correct answer: C

Rationale: The correct answer is C: 'Decreased urine output.' Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by excessive release of antidiuretic hormone, leading to water retention and decreased urine output. Therefore, the nurse should expect the client to have decreased urine output. Choices A, B, and D are incorrect. Hypernatremia (Choice A) is not typically associated with SIADH as it usually leads to dilutional hyponatremia. Hypotension (Choice B) is not a common clinical manifestation of SIADH. Polyuria (Choice D) is the opposite of what is expected in a client with SIADH, who typically presents with decreased urine output.

2. A nurse manager is reviewing data from the unit. More than 50% of new nurses hired left within 1 year of being hired. Which of the following implementations should the nurse manager consider to improve retention of newly hired nurses?

• A. Increase the length of time new hires spend in training.
• B. Conduct a performance review at 3, 6, and 9 months to review the new nurse’s weaknesses.
• C. Stress the importance of continuity of care to new hires.
• D. Build the manager’s own leadership skills through building relationships with staff members.

Correct answer: D

Rationale: To improve retention of newly hired nurses, the nurse manager should focus on building their own leadership skills and relationships with staff members. By creating a supportive environment and demonstrating effective leadership, the manager can positively impact staff retention. Options A, B, and C do not directly address the core issue of creating a supportive work environment and effective leadership, which are crucial for retaining newly hired nurses.

3. Which of the following describes the role of the nurse in advocating for a patient?

• A. The nurse ensures that the patient has all the information needed to make an informed decision about their care.
• B. The nurse advocates for the patient by communicating their needs and preferences to the healthcare team.
• C. The nurse advocates for the patient by ensuring that they receive the care they need and by protecting their rights.
• D. The nurse advocates for the patient by helping them navigate the healthcare system and access necessary resources.

Correct answer: C

Rationale: The correct answer is C. Nurses advocate for patients by ensuring that they receive the necessary care and by protecting their rights. This involves speaking up for patients, ensuring they are treated with respect, and helping them access appropriate healthcare services. Option A, providing information for informed decision-making, is an important aspect of nursing care but not the central role of advocacy. Option B, communicating patients' needs to the healthcare team, is essential but more focused on teamwork and collaboration. Option D, helping patients navigate the healthcare system and access resources, is valuable but not the primary definition of advocacy in nursing.

4. The client has been diagnosed with primary aldosteronism. Which of the following clinical findings would the nurse expect?

• A. Hyperkalemia
• B. Hypokalemia
• C. Hyponatremia
• D. Hypercalcemia

Correct answer: B

Rationale: Primary aldosteronism involves the overproduction of aldosterone by the adrenal glands. Aldosterone increases potassium excretion, leading to hypokalemia. Therefore, in primary aldosteronism, the nurse would expect to find hypokalemia, not hyperkalemia (choice A), hyponatremia (choice C), or hypercalcemia (choice D).

5. Albert, a 35-year-old insulin-dependent diabetic, is admitted to the hospital with a diagnosis of pneumonia. He has been febrile since admission. His daily insulin requirement is 24 units of NPH. Every morning Albert is given NPH insulin at 0730. Meals are served at 0830, 1230, and 1830. The nurse expects that the NPH insulin will reach its maximum effect (peak) between the hours of:

• A. 1130 and 1330.
• B. 1330 and 1930.
• C. 1530 and 2130.
• D. 1730 and 2330.

Correct answer: C

Rationale: NPH insulin typically peaks 4-12 hours after administration, so a peak between 1530 and 2130 would be expected. Choice A (1130 and 1330) is too early for the peak effect of NPH insulin. Choice B (1330 and 1930) falls within the possible peak period but is not as accurate as choice C. Choice D (1730 and 2330) is too late for the peak effect of NPH insulin based on the typical peak timing.

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