Nursing Elites

1. The healthcare provider is using Cognitive-Behavioral methods of pain control and knows that these methods can be expected to do all the following except:

• A. completely relieve all pain.
• B. provide benefit by restoring the client's sense of self-control.
• C. help the client to control symptoms.
• D. help the client actively participate in his or her care.

Correct answer: A

Rationale: Cognitive-Behavioral methods of pain control aim to provide benefit by restoring the client's sense of self-control, helping the client to control symptoms, and encouraging the client to actively participate in their care. However, these methods are not intended to completely relieve all pain. These interventions focus on perception and thought, aiming to influence how one interprets events and bodily sensations. Therefore, the correct answer is that they cannot completely relieve all pain, as pain relief is often a multifaceted approach that may require additional interventions beyond Cognitive-Behavioral methods. Choices B, C, and D are correct as Cognitive-Behavioral methods are designed to empower the individual in managing their pain and improving their overall well-being.

2. Regardless of their practice area, nurses should be concerned with:

• A. all drug-resistant bacteria.
• B. microorganisms that are critical.
• C. transmission of microorganisms.
• D. overprescription of bacteriostatic drugs.

Correct answer: C

Rationale: All nurses should be concerned with preventing the transmission of microorganisms to themselves and others. A primary way to achieve this is through asepsis. Nursing practice emphasizes providing a safe environment to shield clients, family, and healthcare providers from infections. Choices A, B, and D are incorrect. While drug-resistant bacteria, critical microorganisms, and overprescription of bacteriostatic drugs are important, nurses' primary focus should be on preventing microorganism transmission to ensure safety and well-being.

3. What is the most likely reason for a hospitalized adult client who routinely works from midnight until 8 a.m. to have a temperature of 99.1�F at 4 a.m.?

• A. delta sleep
• B. slow brain waves
• C. pneumonia
• D. circadian rhythm

Correct answer: D

Rationale: The correct answer is 'circadian rhythm.' Circadian rhythms are biological cycles that last about 24 hours. The sleep-wake cycle is closely tied to circadian rhythms, affecting body temperature. Normally, core body temperature drops during sleep, reaching its 24-hour low around 4 a.m. In this case, the client's temperature of 99.1�F at 4 a.m. is likely due to the disruption of their circadian rhythm caused by working from midnight until 8 a.m. Choices A, B, and C are incorrect because delta sleep, slow brain waves, and pneumonia do not directly explain the temperature fluctuation based on circadian rhythm.

4. Which is the correct order regarding the hierarchy of members of the nursing team from least authority to highest authority?

• A. LPN, staff nurse, charge nurse, nurse manager
• B. Staff nurse, LPN, nurse manager, charge nurse
• C. LPN, staff nurse, charge nurse, nurse manager
• D. LPN, staff nurse, charge nurse, nurse manager

Correct answer: C

Rationale: The correct hierarchy order from least to highest authority in the nursing team is LPN (Licensed Practical Nurse), staff nurse, charge nurse, and nurse manager. LPNs have the least authority, followed by staff nurses who are supervised by charge nurses. Nurse managers oversee the charge nurses, making them the highest authority in this hierarchy. Therefore, choices A, B, and D are incorrect as they do not follow the correct order of authority within the nursing team.

5. For which condition might a client's antidiuretic hormone (ADH) level be increased?

• A. diabetes mellitus
• B. diabetes insipidus
• C. hypothyroidism
• D. hyperthyroidism

Correct answer: B

Rationale: The correct answer is diabetes insipidus. In this condition, the client's ADH level is increased. Diabetes insipidus is characterized by the inability of the kidneys to conserve water due to either inadequate secretion of ADH (central diabetes insipidus) or the kidneys' inability to respond to ADH (nephrogenic diabetes insipidus). Choices A, C, and D are incorrect. In diabetes mellitus, ADH levels are typically normal or elevated in response to high blood sugar levels. Hypothyroidism is not directly related to ADH secretion. In hyperthyroidism, ADH levels are usually normal or decreased.

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