Nursing Elites

1. Which of the following statements is true regarding ethical principles and laws?

• A. The government enforces ethics.
• B. Laws establish standards that aid in decision-making.
• C. Ethics are highly specific.
• D. Ethical principles can serve as the foundation for laws.

Correct answer: D

Rationale: The correct answer is D. Ethical principles can influence the creation of laws but are not equivalent to laws themselves. Laws are established by governing bodies to provide a framework for society, whereas ethical principles guide individuals' moral conduct. Choice A is incorrect because governments enforce laws, not ethics. Choice B is incorrect as laws set legal standards rather than ethical ones. Choice C is incorrect because ethics are principles that guide behavior but are not necessarily highly specific.

2. A client is receiving levothyroxine for hypothyroidism. Which of the following findings would indicate that the medication is effective?

• A. Decreased heart rate
• B. Increased weight
• C. Increased energy levels
• D. Decreased appetite

Correct answer: C

Rationale: The correct answer is C: Increased energy levels. When a client with hypothyroidism is receiving levothyroxine, increased energy levels indicate that thyroid hormone levels are being normalized, which is a positive response to treatment. This improvement reflects the effectiveness of the medication in addressing the underlying hypothyroidism. Choices A, B, and D are incorrect. Decreased heart rate and decreased appetite may be symptoms of hypothyroidism and would not necessarily indicate the effectiveness of levothyroxine. Increased weight could also be a symptom of hypothyroidism and does not directly reflect the medication's effectiveness.

3. The client with Addison's disease is receiving education on managing the condition. Which of the following instructions should be included?

• A. Increase your sodium intake during periods of stress.
• B. Avoid all types of exercise.
• C. Decrease your fluid intake to prevent fluid overload.
• D. Stop corticosteroid therapy once symptoms improve.

Correct answer: A

Rationale: The correct instruction to include for a client with Addison's disease is to increase sodium intake during periods of stress. In Addison's disease, there is a deficiency of aldosterone leading to sodium loss. Increasing sodium intake helps to compensate for this loss and prevent complications. Choice B is incorrect as exercise is beneficial for overall health but should be done in moderation. Choice C is incorrect as fluid intake should be adequate to prevent dehydration since clients with Addison's disease are prone to electrolyte imbalances. Choice D is incorrect as corticosteroid therapy is essential for managing Addison's disease and should not be discontinued abruptly without medical guidance.

4. A nurse caring for a group of clients reviews the electrolyte laboratory results and notes a potassium level of 5.5 mEq/L on one client's laboratory report. The nurse understands that which client is at highest risk for the development of a potassium value at this level?

• A. The client with colitis
• B. The client with Cushing's syndrome
• C. The client who has been overusing laxatives
• D. The client who has sustained a traumatic burn

Correct answer: D

Rationale: Clients who have sustained traumatic burns are at a higher risk of developing hyperkalemia due to cell lysis. When cells are damaged in a traumatic burn, potassium can leak out from the intracellular space into the bloodstream, leading to elevated serum potassium levels. Colitis, Cushing's syndrome, and overuse of laxatives are not typically associated with the same degree of cell damage or potassium shifts seen in traumatic burns, making them less likely to result in such high potassium levels.

5. What is the nurse's responsibility when dealing with an impaired colleague?

• A. The nurse should report the colleague to a supervisor and follow the institution's policy for addressing impaired practice.
• B. The nurse should confront the colleague directly and offer support to seek help for the impairment.
• C. Nonmaleficence
• D. The nurse should ignore the colleague's behavior and focus on their own responsibilities.

Correct answer: A

Rationale: When a nurse encounters an impaired colleague, the appropriate action is to report the behavior to a supervisor and follow the institution's policy for addressing impaired practice. This ensures patient safety and upholds professional standards. Choice B is incorrect because confronting the colleague directly may not be appropriate or effective in addressing the issue, and the colleague may need more structured assistance. Choice C is a principle of ethical practice but does not directly address the specific situation of dealing with an impaired colleague. Choice D is incorrect because ignoring the colleague's behavior could potentially compromise patient safety and is not in line with professional responsibility.

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