Nursing Elites

1. 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.

2. A patient's serum potassium level is 2.2 mEq/L. Which nursing action is the highest priority for this patient?

• A. Start oxygen at 2 L/min
• B. Initiate cardiac monitoring
• C. Initiate seizure precautions
• D. Keep the patient on bed rest

Correct answer: B

Rationale: The correct answer is to initiate cardiac monitoring. Severe hypokalemia can lead to life-threatening arrhythmias, making cardiac monitoring the priority to detect and manage any cardiac complications. Starting oxygen, seizure precautions, or bed rest are not the immediate priority actions for severe hypokalemia.

3. Which of the following is true regarding the Affordable Care Act?

• A. The Affordable Care Act addressed issues of interest to nursing without controversy.
• B. The Affordable Care Act addressed issues of mandatory overtime, incivility, and high workloads for nurses.
• C. The Affordable Care Act provided a new patient-centered model for health care.
• D. The Affordable Care Act attempted to address many of the issues of interest to nursing, but came with much controversy.

Correct answer: D

Rationale: The correct answer is D. The Affordable Care Act attempted to address many issues relevant to nursing, such as mandatory overtime, incivility, and high workloads, but it faced significant controversy. Choice A is incorrect as the act did not address nursing issues without controversy. Choice B is incorrect as it inaccurately lists the issues the act addressed. Choice C is incorrect as it does not fully capture the controversy surrounding the Affordable Care Act.

4. A nurse is preparing to discharge a client who has end-stage heart failure. The client's partner tells the nurse she can no longer handle caring for the client. Which of the following actions should the nurse take?

• A. Request another family member to assist the client's partner with care
• B. Recommend the partner to place the client in a long-term care facility
• C. Contact the case manager to discuss discharge options
• D. Ask the provider to delay the client's discharge home for a few more days

Correct answer: C

Rationale: The nurse should contact the case manager to discuss discharge options and support the client's partner. This action is appropriate as it involves seeking professional guidance and support for the client's partner who is struggling to care for the client. Option A is not the best choice as it solely focuses on involving another family member without addressing the partner's concerns directly. Option B is premature as recommending long-term care should be a well-considered decision involving multiple healthcare professionals. Option D delays the inevitable without providing a solution to the partner's current challenges.

5. Select the ethical principles that are paired with their descriptions. Select the one that does not apply.

• A. Justice: Being honest and fair
• B. Beneficence: Doing good
• C. Veracity: Truthfulness
• D. Self-determination: Facilitating patient choices

Correct answer: C

Rationale: The correct answer is C. Veracity is the principle of truthfulness, not treating all patients equally. Choice A is correct as Justice involves being honest and fair. Choice B is correct as Beneficence is about doing good. Choice D is correct as Self-determination is about respecting and facilitating patient choices.

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