Nursing Elites

1. What is the appropriate action when a patient refuses treatment for religious reasons?

• A. Respect the patient's decision
• B. Persuade the patient to accept treatment
• C. Inform the healthcare provider
• D. Document the refusal

Correct answer: A

Rationale: The correct answer is to respect the patient's decision. When a patient refuses treatment for religious reasons, it is crucial to respect their autonomy and beliefs. Persuading the patient to accept treatment could violate their rights and autonomy, going against ethical principles. Informing the healthcare provider is important, but the immediate action should be to respect the patient's decision first. Documenting the refusal is necessary for legal and documentation purposes, but it should not override respecting the patient's autonomy and right to refuse treatment based on religious beliefs.

2. A nurse in an emergency department is caring for a client who reports cocaine use 1 hour ago. Which of the following findings should the nurse expect?

• A. Hypotension.
• B. Memory loss.
• C. Slurred speech.
• D. Elevated temperature.

Correct answer: D

Rationale: The correct answer is D: Elevated temperature. Cocaine is a stimulant drug that can lead to increased body temperature. Hypotension (Choice A) is less likely as cocaine tends to elevate blood pressure. Memory loss (Choice B) and slurred speech (Choice C) are more commonly associated with depressant drugs rather than stimulant drugs like cocaine.

3. A client with vision loss is being cared for by a nurse. Which of the following actions should the nurse take?

• A. Keep objects in the client's room in the same place
• B. Ensure there is high-wattage lighting in the client's room
• C. Approach the client from the side
• D. Touch the client gently to announce presence

Correct answer: A

Rationale: The correct action for the nurse to take is to keep objects in the client's room in the same place. This helps individuals with vision loss navigate their environment more easily by creating a familiar and consistent layout. Choice B, ensuring high-wattage lighting, may not be suitable for all clients with vision loss and can cause discomfort or glare. Approaching the client from the side (Choice C) can startle them and is not recommended. Touching the client (Choice D) without warning may cause anxiety or distress, so it's important to announce presence verbally.

4. A nurse is caring for a client who has chronic kidney disease. The nurse should identify which of the following laboratory values as an indication for hemodialysis?

• A. Glomerular filtration rate of 14 mL/min
• B. BUN 16 mg/dL
• C. Serum magnesium 1.8 mg/dL
• D. Serum phosphorus 4.0 mg/dL

Correct answer: A

Rationale: A glomerular filtration rate (GFR) of 14 mL/min is significantly low, indicating poor kidney function and the need for hemodialysis to remove waste products effectively. BUN, serum magnesium, and serum phosphorus levels are important in assessing kidney function and electrolyte balance but are not direct indicators for the initiation of hemodialysis. BUN (blood urea nitrogen) reflects the kidney's ability to filter waste products, serum magnesium levels are important for muscle and nerve function, and serum phosphorus levels are vital for bone health.

5. A nurse is caring for a client who has experienced intimate partner violence. What is the nurse's priority?

• A. Develop a safety plan with the client.
• B. Refer the client to a community support group.
• C. Determine if the client has any injuries.
• D. Contact the client's family about the incident.

Correct answer: A

Rationale: The correct answer is A: 'Develop a safety plan with the client.' When caring for a client who has experienced intimate partner violence, the nurse's priority is to ensure the client's safety. Developing a safety plan is essential to address the immediate safety concerns and provide support to the client. Referring the client to a community support group, as in option B, may be beneficial but is not the immediate priority. While determining if the client has any injuries, as in option C, is important for assessing physical well-being, the priority is to address safety concerns first. Contacting the client's family about the incident, as in option D, is not appropriate without the client's consent and may further endanger the client.

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