Nursing Elites

1. Which nursing diagnosis is commonly used among patients affected by fibromyalgia?

• A. Decreased self-care in activities of daily living related to fatigue
• B. Impaired mental functioning related to electrolyte imbalances
• C. Increased vigilance secondary to electrolyte imbalances
• D. At risk for a swallowing disorder related to fibromyalgia

Correct answer: A

Rationale: The correct answer is A: 'Decreased self-care in activities of daily living related to fatigue.' Patients with fibromyalgia commonly experience fatigue, which can lead to decreased ability to perform self-care activities. This nursing diagnosis addresses a direct consequence of fibromyalgia. Choices B, C, and D are incorrect because they do not directly correlate with the common manifestations of fibromyalgia. Impaired mental functioning related to electrolyte imbalances and increased vigilance secondary to electrolyte imbalances are not typical presentations of fibromyalgia. 'At risk for a swallowing disorder related to fibromyalgia' is not a common nursing diagnosis associated with fibromyalgia; swallowing disorders are not a primary symptom of this condition.

2. You have just learned that another nurse was fired for taking photographs of patients without their permission using a cell phone and posting them on Facebook. This nurse was fired because the nurse had:

• A. Violated the law
• B. Acted in a negligent manner
• C. Not completed the proper documentation
• D. Violated an ethical principle

Correct answer: A

Rationale: The correct answer is A: Violated the law. Taking and sharing patient photographs without consent is a violation of patient privacy laws, hence the nurse was fired for breaking the law. Choice B, acting in a negligent manner, is incorrect as the nurse's actions were intentional and not due to negligence. Choice C, not completing proper documentation, is unrelated to the situation described. Choice D, violating an ethical principle, is not specific enough as the primary reason for the nurse's termination was the legal breach regarding patient privacy.

3. The doctor has ordered 20 cc per hour of normal saline intravenously for your pediatric patient. You will be using pediatric intravenous tubing that delivers 60 cc per drop. How many drops per minute will you administer using this pediatric intravenous set?

• A. 30 drops per minute
• B. 25 drops per minute
• C. 20 drops per minute
• D. 22 drops per minute

Correct answer: C

Rationale: To calculate the drops per minute, first convert the ordered amount to drops per minute. 20 cc per hour equals 20 drops per hour with 60 cc per drop tubing, which is equivalent to 20 drops per hour * 60 cc per drop = 1200 drops per hour. To find drops per minute, divide 1200 by 60 (minutes in an hour), which equals 20 drops per minute. Therefore, the correct answer is 20 drops per minute. Choices A, B, and D are incorrect as they do not reflect the correct calculation based on the provided information.

4. A nurse is receiving a verbal prescription from the provider for a client who is experiencing increased pain. The nurse should transcribe which of the following prescriptions in the client's medical record?

• A. Morphine sulfate 10 mg IV q 4 IV prn for pain
• B. MS 10 mg IV every 4 8 prn for pain
• C. MSO4 10 mg IVP q 4 8 prn for pain
• D. Morphine sulfate 10.0 mg every 4 hours IV prn for pain

Correct answer: A

Rationale: The correct transcription is 'Morphine sulfate 10 mg IV q 4 IV prn for pain.' In choice A, 'Morphine sulfate 10 mg IV q 4 IV prn for pain' correctly indicates the medication, route (IV), frequency (every 4 hours), and administration as needed for pain control. Choice B is incorrect as 'MS' is not a standard abbreviation for Morphine Sulfate, and the frequency 'every 4 8' is not a valid time interval. Choice C is incorrect as 'MSO4' is not the standard abbreviation for Morphine Sulfate, and 'IVP' is not the standard route abbreviation for intravenous. Choice D is incorrect as it lacks clarity with '10.0 mg' instead of '10 mg,' and the frequency is given as 'every 4 hours' without specifying the route of administration.

5. What are some of the earliest signs and symptoms of Duchenne's muscular dystrophy?

• A. Clumsiness, difficulty running, climbing, and riding a bicycle
• B. Pain and inflammation in the bones
• C. Deformity of the foot
• D. Infection in the joint leading to arthritis

Correct answer: A

Rationale: The correct answer is A: Clumsiness, difficulty running, climbing, and riding a bicycle are some of the earliest signs and symptoms of Duchenne's muscular dystrophy. Duchenne's muscular dystrophy is a genetic disorder characterized by progressive muscle degeneration and weakness. Choices B, C, and D are incorrect because they do not represent the typical early signs and symptoms of Duchenne's muscular dystrophy. Pain and inflammation in the bones (choice B) are more indicative of conditions like osteomyelitis; deformity of the foot (choice C) is characteristic of talipes or clubfoot; and infection in the joint leading to arthritis (choice D) is more aligned with septic joint or supportive arthritis.

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