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. A client with DM states, 'I cannot eat big meals; I prefer to snack throughout the day.' The nurse should carefully explain that the:

• A. Regulated food intake is crucial for control
• B. Restricting salt and sugar is the main concern
• C. Opting for small, frequent meals aids digestion
• D. Consuming large meals can contribute to weight issues

Correct answer: A

Rationale: In clients with diabetes, regulated food intake is crucial for controlling blood glucose levels. Choice A is the correct answer because maintaining consistent meal sizes and timings helps in managing blood sugar levels effectively. Choice B is incorrect because while monitoring salt and sugar intake is important, it is not the primary consideration in this scenario. Choice C is incorrect as the focus is on regulating food intake rather than aiding digestion. Choice D is also incorrect because consuming large meals can indeed lead to fluctuations in blood glucose levels, but the primary concern in this case is the regulation of food intake for better control of diabetes.

3. A hospice nurse is caring for a client who has a terminal illness and reports severe pain. After the nurse administers the prescribed opioid and benzodiazepine, the client becomes somnolent and difficult to arouse. Which of the following actions should the nurse take?

• A. Withhold the benzodiazepine but continue the opioid
• B. Contact the provider about replacing the opioid with an NSAID
• C. Administer the benzodiazepine but withhold the opioid
• D. Continue the medication dosages that relieve the client's pain

Correct answer: B

Rationale: The correct action for the nurse to take is to contact the provider about replacing the opioid with an NSAID. In this scenario, the client is experiencing excessive sedation after the administration of both opioid and benzodiazepine. Switching to a non-opioid analgesic like an NSAID can help manage pain effectively without causing additional sedation. Option A is incorrect because continuing the opioid may exacerbate sedation. Option C is incorrect as administering the benzodiazepine may further increase sedation. Option D is incorrect because maintaining the current medication dosages that are causing excessive sedation is not in the client's best interest.

4. Which of the following actions can an individual nurse take to exert leadership in supporting the profession of nursing?

• A. Join a local professional organization.
• B. Talk about healthcare issues to everyone who will listen, including legislators.
• C. Register to vote.
• D. Learn about the healthcare system.

Correct answer: B

Rationale: Engaging in conversations about healthcare issues with a wide audience, including legislators, is a powerful way for a nurse to exert leadership and support the nursing profession. This action helps raise awareness, advocate for nursing-related matters, and contribute to positive changes in healthcare policies. Choice A, joining a local professional organization, is beneficial but may not have the same broad impact as engaging in public discourse. Choice C, registering to vote, is important for civic engagement but does not directly relate to exerting leadership in supporting the nursing profession. Choice D, learning about the healthcare system, is valuable for personal development but does not directly address exerting leadership in supporting the nursing profession.

5. Your long-term care patient has chronic pain and at this point in time, the patient needs increasing dosages to adequately control this pain. What is this patient most likely affected by?

• A. Drug addiction
• B. Drug interactions
• C. Drug side effects
• D. Drug tolerance

Correct answer: D

Rationale: The correct answer is D: Drug tolerance. When a patient needs increasing dosages to achieve the same pain relief, it indicates the development of drug tolerance. This means the body has adapted to the drug, requiring higher doses to produce the same effect. Choice A, drug addiction, is incorrect because drug addiction involves a psychological and physical dependence on the drug, which is not described in the scenario. Choice B, drug interactions, is incorrect as it refers to the effects when multiple drugs interact with each other, not the situation described. Choice C, drug side effects, is also incorrect as it pertains to the unintended effects of a drug, not the need for higher doses to control pain.

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