Nursing Elites

1. Which of the following differentiates ulcerative colitis from Crohn's disease?

• A. Crohn's disease primarily affects the left colon and rectum, while ulcerative colitis most often affects the right colon and distal ileum.
• B. Crohn's disease presents with shallow ulcerations, whereas ulcerative colitis presents with a cobblestone appearance of the mucosal lining.
• C. The extent of involvement is noncontiguous and segmented with Crohn's disease, whereas it is contiguous and diffuse with ulcerative colitis.
• D. Crohn's disease has primarily mucosal involvement, whereas it is transmural with ulcerative colitis.

Correct answer: C

Rationale: The correct answer is C. Crohn's disease is characterized by noncontiguous, segmented involvement, meaning it can affect different areas with healthy tissue in between, while ulcerative colitis involves continuous areas of inflammation. Choices A, B, and D are incorrect because Crohn's disease can affect any part of the digestive tract from mouth to anus, can present with shallow ulcerations or deep fissures, and is transmural, meaning it affects the entire thickness of the bowel wall. On the other hand, ulcerative colitis typically affects the colon and rectum, presents with a continuous pattern of inflammation, and primarily involves the mucosal lining of the colon.

2. Which patient is exercising their right to autonomy in the context of patient rights?

• A. An 86-year-old female who remains independent in terms of the activities of daily living.
• B. An unemancipated 16-year-old who chooses to not have an intravenous line.
• C. A 32-year-old who does not need the help of the nurse to bathe and groom themselves.
• D. A 99-year-old who wants CPR despite the fact that the nurse and doctor do not think that it would be successful.

Correct answer: D

Rationale: The correct answer is D. A 99-year-old exercising their right to autonomy in the context of patient rights by choosing CPR. Autonomy in healthcare refers to the patient's right to make their own decisions about their care, even if healthcare providers may disagree. In this scenario, the 99-year-old patient is exercising autonomy by making an informed choice about their medical treatment, despite healthcare professionals having a different opinion. Choices A, B, and C do not directly demonstrate the exercise of autonomy in decision-making regarding medical treatment, making them incorrect.

3. A nurse in a clinic is reviewing laboratory reports for a group of clients. Which of the following diseases should the nurse report to the state health department?

• A. Pertussis
• B. Group B streptococcal disease
• C. Respiratory syncytial virus
• D. Rotavirus

Correct answer: A

Rationale: Pertussis is the correct answer because it is a reportable disease that healthcare providers are required by law to report to public health authorities. This infectious disease poses a significant public health risk and needs to be monitored closely to prevent outbreaks and implement control measures. Group B streptococcal disease, Respiratory syncytial virus, and Rotavirus are important conditions but are not typically reportable to the state health department. These diseases may require specific precautions in healthcare settings, but they do not fall under mandatory reporting requirements.

4. The healthcare provider provides instructions to a client with a low magnesium level about the foods that are high in magnesium and tells the client to consume which foods? Select one that does not apply.

• A. Peas
• B. Oranges
• C. Apples
• D. Peanut butter

Correct answer: B

Rationale: Oranges are not high in magnesium. The other choices, such as peas, are good sources of magnesium. Peas, along with cauliflower and canned white tuna, are foods rich in magnesium. Oranges, although healthy, are not known for their high magnesium content.

5. A nurse is providing an in-service about client rights for a group of nurses. Which of the following statements should the nurse include in the service?

• A. A nurse can disclose information to a family member with the client's permission
• B. A nurse can apply restraints on an as-needed basis
• C. A nurse can administer medications without consent to a client as part of a research study
• D. A nurse is responsible for informing clients about treatment options

Correct answer: A

Rationale: The correct statement to include in the in-service about client rights is that a nurse can disclose information to a family member with the client's permission. This respects the client's autonomy and privacy. Choice B is incorrect because restraints should only be applied based on a specific assessment and order, not on an as-needed basis. Choice C is incorrect as administering medications without consent is a violation of ethical principles and legal standards. Choice D is incorrect because while nurses should educate clients about treatment options, the ultimate decision lies with the client after being informed.

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