Nursing Elites

1. Which of the following is an example of an ethical dilemma in nursing?

• A. Choosing between two equally undesirable alternatives
• B. Reporting a colleague's unethical behavior
• C. Balancing patient confidentiality with the need to disclose information
• D. Deciding whether to comply with a patient's request that conflicts with professional ethics

Correct answer: D

Rationale: The correct answer is D. An ethical dilemma in nursing involves deciding whether to comply with a patient's request that conflicts with professional ethics, balancing competing values and principles. Choices A, B, and C do not directly represent ethical dilemmas in nursing. Choice A describes a general ethical dilemma, choice B involves professional conduct rather than a dilemma, and choice C refers to a confidentiality issue rather than conflicting ethical principles.

2. A nurse is assessing a client who reports increased pain following physical therapy. Which of the following questions should the nurse ask when assessing the quality of the client's pain?

• A. Is your pain constant or intermittent?
• B. What would you rate your pain on a scale of 0 to 10?
• C. Does the pain radiate?
• D. Is your pain sharp or dull?

Correct answer: D

Rationale: When assessing the quality of pain, asking if the pain is sharp or dull helps the nurse understand the nature of the pain. Sharp pain is often associated with acute conditions like nerve irritation or injury, while dull pain may indicate a more chronic issue like inflammation or tissue damage. Choices A, B, and C focus on different aspects of pain assessment but do not specifically address the quality of pain, making them less relevant in this context.

3. A client with frequent tonic-clonic seizures is being admitted. What action should the nurse add to the client's plan of care?

• A. Ensure blankets are placed on all four sides of the bed.
• B. Refrain from using restraints during seizure activity.
• C. Position the client laterally during seizure activity.
• D. Have a tongue depressor available at the client's bedside.

Correct answer: D

Rationale: The correct action the nurse should add to the client's plan of care is to have a tongue depressor available at the client's bedside. This is important during a seizure to prevent the client from biting their tongue. Placing the client laterally helps maintain a clear airway and prevents aspiration, making choice C a good practice during seizure activity. Using restraints during a seizure can cause injuries and should be avoided, making choice B incorrect. Wrapping blankets around all four sides of the bed is unnecessary for seizure management and does not contribute to the client's safety during a seizure, making choice A incorrect.

4. A nurse has just inserted a nasogastric (NG) tube for a client. Which of the following findings should the nurse expect to confirm correct tube placement?

• A. The client reports relief of nausea.
• B. The tube aspirate has a pH less than 5.
• C. Bowel sounds are present on auscultation.
• D. An x-ray shows the end of the tube above the pylorus.

Correct answer: A

Rationale: The correct answer is A: The client reports relief of nausea. When the NG tube is correctly placed in the stomach, it can help alleviate feelings of nausea and discomfort. Choice B, a tube aspirate pH less than 5, is incorrect as it indicates gastric placement, not necessarily correct placement. Choice C, bowel sounds on auscultation, and Choice D, visualization of the tube on an x-ray above the pylorus, do not confirm correct NG tube placement; therefore, they are incorrect.

5. A nurse is assessing a client's readiness to learn about insulin self-administration. Which of the following statements should the nurse identify as an indication that the client is ready to learn?

• A. "I can concentrate best in the morning."
• B. "It is difficult to read the instructions because my glasses are at home."
• C. "I'm wondering why I need to learn this."
• D. "You will have to talk to my partner about this."

Correct answer: D

Rationale: The correct answer is D, "You will have to talk to my partner about this." This response indicates that the client is willing to involve their partner in the learning process, showing readiness to take responsibility and engage in the education. Choices A, B, and C demonstrate potential barriers to learning: A indicates a preference for learning time but does not show active involvement, B focuses on external factors hindering learning, and C reflects a lack of understanding or motivation for the learning.

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