Nursing Elites

1. Nurses caring for clients who have cancer and are taking opioids need to assess for all of the following except:

• A. tolerance.
• B. constipation.
• C. sedation.
• D. addiction.

Correct answer: D

Rationale: When caring for clients with cancer who are taking opioids, nurses need to assess for tolerance, constipation, and sedation as these are common side effects of opioid use. Addiction, however, is not a primary concern when treating pain in terminally ill clients. Terminally ill patients are usually not at risk of developing addiction to opioids due to their short life expectancy and the focus on pain management rather than the potential for addiction. Therefore, the correct answer is 'addiction.' Choices A, B, and C are essential considerations when managing clients on opioids for pain control.

2. Ethical and moral issues concerning restraints include all of the following except:

• A. emotional impact on the client and family.
• B. dignity of the client.
• C. client's quality of life.
• D. policies and procedures.

Correct answer: D

Rationale: The correct answer is 'policies and procedures.' While policies and procedures are essential for managing restraints, they are not in themselves ethical or moral issues. The emotional impact on the client and family, the dignity of the client, and the client's quality of life are all ethical and moral concerns related to the use of restraints. These aspects focus on the well-being, respect, and rights of the individual, which are fundamental ethical considerations in healthcare practice. Choices A, B, and C are directly tied to ethical and moral considerations by highlighting the impact on individuals involved and their overall quality of life and dignity, making them key factors to address in ethical decision-making.

3. During an annual physical exam, a client is diagnosed with Benign Prostatic Hyperplasia (BPH). This client is likely to have a consult with which type of physician?

• A. gynecologist
• B. physiatrist
• C. urologist
• D. proctologist

Correct answer: C

Rationale: A client diagnosed with Benign Prostatic Hyperplasia (BPH) would typically have a consult with a urologist. Urologists specialize in urinary tract and prostatic diseases, making them the appropriate choice for managing BPH. A gynecologist focuses on diseases of the female reproductive tract, so they are not relevant in this case. A physiatrist specializes in rehabilitation care, which is not directly related to the treatment of BPH. A proctologist specializes in lower colonic digestive diseases, which are unrelated to BPH.

4. A client with leukemia is being considered for a bone marrow transplant. The healthcare team is discussing the risks and benefits of this treatment and other possible treatments with the goal of inflicting the least possible harm on the client. Which principle of healthcare ethics is the team practicing?

• A. Fidelity
• B. Nonmaleficence
• C. Autonomy
• D. Justice

Correct answer: B

Rationale: The correct answer is B: Nonmaleficence. Nonmaleficence is the principle of avoiding harm. In healthcare ethics, practitioners aim not only to do good but also to ensure they do no harm. In this scenario, the healthcare team is discussing treatment options with the intention of inflicting the least harm on the client. Choice A, Fidelity, refers to keeping promises made to clients, families, and healthcare professionals. Choice C, Autonomy, pertains to respecting a person's independence and right to make decisions. Choice D, Justice, involves fairness, equity, and the fair allocation of resources, such as healthcare services.

5. Which of the following lab values is associated with a decreased risk of cardiovascular disease?

• A. high HDL cholesterol
• B. low HDL cholesterol
• C. low total cholesterol
• D. low triglycerides

Correct answer: A

Rationale: The correct answer is high HDL cholesterol. High HDL cholesterol levels are associated with a decreased risk of cardiovascular disease because HDL helps remove LDL cholesterol from the arteries, reducing plaque buildup. Low HDL cholesterol (choice B) is actually associated with an increased risk of cardiovascular disease. Low total cholesterol (choice C) or low triglycerides (choice D) are not indicators of a decreased risk of cardiovascular disease; in fact, extremely low total cholesterol levels may indicate other health issues.

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