Nursing Elites

1. Which of the following is not typically considered one of the main mechanisms of Type II Diabetes treatment?

• A. Medications
• B. Nutrition
• C. Increased activity
• D. Continuous Insulin

Correct answer: D

Rationale: Continuous Insulin is not typically considered one of the main mechanisms for treating Type II Diabetes. While medications, nutrition, and increased activity play crucial roles in managing Type II Diabetes, continuous insulin therapy is more common in Type I Diabetes or in specific cases of Type II Diabetes where other treatments are ineffective. Therefore, the correct answer is Continuous Insulin. Choices A, B, and C are mainstays in the treatment of Type II Diabetes, making them incorrect answers.

2. Which of the following goals is the most important for the nurse to address for a client admitted to the cardiac rehabilitation unit?

• A. Reduction of anxiety
• B. Referral to community resources
• C. Identification of lifestyle changes
• D. Verbalization of energy-conservation techniques

Correct answer: C

Rationale: The most important goal for a client admitted to the cardiac rehabilitation unit is the identification of lifestyle changes. This is crucial in promoting cardiovascular health and preventing future cardiac issues. Lifestyle changes such as diet modifications, exercise routines, smoking cessation, and stress management play a significant role in improving the overall cardiovascular well-being of the patient. While reducing anxiety, referring to community resources, and verbalizing energy-conservation techniques are all important aspects of care, identifying lifestyle changes is the primary focus in helping the client achieve long-term cardiovascular wellness.

3. A patient had a pneumonectomy to the right lung performed 48 hours ago. Which of the following conditions most likely exists?

• A. Decreased breath sound volume
• B. Elevated tidal volume
• C. Elevated respiratory capacity
• D. Wheezing

Correct answer: A

Rationale: After a pneumonectomy, where a lung is surgically removed, there will be a decrease in breath sound volume on the affected side due to reduced airflow. This reduction in breath sound volume is expected as there is less lung tissue to produce sound. Choices B, C, and D are incorrect. Elevated tidal volume and respiratory capacity are not expected after a pneumonectomy, and wheezing is more commonly associated with conditions like asthma or bronchitis, not a recent pneumonectomy.

4. A one-month-old infant in the neonatal intensive care unit is dying. The parents request that the nurse administer an opioid analgesic to their infant, who is crying weakly. The infant's heart rate is 68 beats per minute, and the respiratory rate is 18 breaths per minute. The infant is on room air, and the oxygen saturation is 92%. The nurse's response is based on which of the following principles?

• A. Providing analgesia during the last days and hours is an ethically appropriate nursing action.
• B. Withholding the opioid analgesia during the last days and hours is an ethical duty because administering it would represent assisted suicide.
• C. Administering analgesia during the last days and hours is the parents' ethical decision.
• D. Withholding the opioid analgesia is clinically appropriate because it will hasten the infant's death.

Correct answer: A

Rationale: All patients, regardless of age, have the right to die with dignity and be free from pain. In this case, the parents' request for an opioid analgesic to relieve the child's distress aligns with the principles of palliative care and ensuring comfort. Assisted suicide involves a conscious decision by the individual, which is not applicable to a 1-month-old infant. Both the nurse and the parents have an ethical duty to ensure the infant's comfort and well-being. Withholding opioid analgesia solely to hasten death is not appropriate, as providing pain relief is a crucial aspect of end-of-life care. Opioids can be administered to dying patients at any age to alleviate suffering without the intention of hastening death. Therefore, providing analgesia during the last days and hours is an ethically appropriate nursing action. Choices B, C, and D are incorrect because the decision to administer analgesia in this scenario is based on the best interest and comfort of the infant, not concerns about assisted suicide or hastening death. The ethical consideration is to provide compassionate care and alleviate suffering.

5. For which adverse effect of the block does the postpartum nurse monitor the woman after receiving a subarachnoid (spinal) block for a cesarean delivery?

• A. Headache
• B. Pruritus
• C. Vomiting
• D. Hypertension

Correct answer: A

Rationale: The correct answer is 'Headache.' Postdural headache is a common adverse effect associated with a subarachnoid block due to cerebrospinal fluid leakage at the site of dural puncture. This headache worsens when the woman is upright and may improve when she lies flat. To manage this headache, bed rest and adequate hydration are recommended. Pruritus, vomiting, and hypertension are not typically associated with subarachnoid blocks. Pruritus, nausea, and vomiting are more commonly linked to the use of intrathecal opioids.

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