Nursing Elites

1. A new nurse is working hard to follow the established procedures on the unit and is focusing on being as efficient as possible. Which of the following best describes this nurse’s behavior?

• A. The nurse is demonstrating the concept of efficiency, which involves following established procedures to complete tasks in the most effective way possible.
• B. The nurse is demonstrating the concept of task orientation, which focuses on completing tasks efficiently without necessarily considering the impact on patient care.
• C. The nurse is demonstrating the concept of patient-centered care, which focuses on providing care that is respectful of and responsive to individual patient preferences and needs.
• D. The nurse is demonstrating the concept of transformational leadership, which involves inspiring and motivating others to achieve a higher level of performance.

Correct answer: A

Rationale: The correct answer is A: The nurse is demonstrating the concept of efficiency by following established procedures to complete tasks effectively. Efficiency in healthcare involves optimizing processes and resources to achieve the best outcomes. Choice B is incorrect as task orientation refers to focusing on task completion without considering broader aspects like patient care. Choice C is incorrect as patient-centered care emphasizes individual patient needs and preferences rather than operational efficiency. Choice D is incorrect as transformational leadership involves inspiring and motivating others, not specifically related to task efficiency.

2. The healthcare provider is providing dietary instructions to a client with hyperthyroidism. Which of the following foods should the client avoid?

• A. Seafood
• B. Spinach
• C. Bananas
• D. Oatmeal

Correct answer: A

Rationale: The client with hyperthyroidism should avoid foods high in iodine, as it can exacerbate the condition by increasing thyroid hormone production. Seafood, particularly ocean fish, is rich in iodine, making it a food to avoid. Spinach, bananas, and oatmeal do not contain high levels of iodine and are generally safe for individuals with hyperthyroidism.

3. The healthcare provider is monitoring a client with Cushing's syndrome. Which of the following findings should be reported to the healthcare provider immediately?

• A. Hyperglycemia
• B. Hypertension
• C. Low-grade fever
• D. Weight gain

Correct answer: C

Rationale: In a client with Cushing's syndrome, a low-grade fever should be reported immediately as it may indicate an infection. Clients with Cushing's syndrome are immunosuppressed, making them more susceptible to infections. Hyperglycemia and hypertension are common findings in Cushing's syndrome and are managed as part of the condition. Weight gain is also a common symptom in Cushing's syndrome and may not require immediate reporting unless it is sudden and severe.

4. The nurse is caring for a client with congestive heart failure. On assessment, the nurse notes that the client is dyspneic and that crackles are audible on auscultation. The nurse suspects excess fluid volume. What additional signs would the nurse expect to note in this client if excess fluid volume is present?

• A. Weight loss
• B. Flat neck and hand veins
• C. An increase in blood pressure
• D. A decreased central venous pressure (CVP)

Correct answer: C

Rationale: An increase in blood pressure is a common sign of fluid volume excess in clients with congestive heart failure due to the increased amount of fluid in the vascular system. Weight loss (Choice A) is not typically associated with fluid volume excess. Flat neck and hand veins (Choice B) are signs of fluid volume deficit, not excess. A decreased central venous pressure (CVP) (Choice D) is not expected in a client with fluid volume excess.

5. A client with type 2 diabetes mellitus is being discharged after receiving initial treatment. What should the nurse emphasize as a crucial instruction?

• A. Take insulin as prescribed, even if you are not eating.
• B. Avoid all forms of physical exercise to prevent hypoglycemia.
• C. Monitor blood glucose levels regularly and report any changes.
• D. Stop taking oral antidiabetic medication if your blood glucose levels are normal.

Correct answer: C

Rationale: Monitoring blood glucose levels regularly is a critical aspect of managing type 2 diabetes mellitus. This allows the individual to track their blood sugar levels, understand the effectiveness of the treatment plan, and detect any fluctuations promptly. Option A is incorrect because insulin should be taken based on a prescribed schedule that correlates with meals to prevent hypoglycemia or hyperglycemia. Option B is incorrect as physical exercise is beneficial for managing diabetes but should be done cautiously with adjustments in insulin or food intake. Option D is incorrect because discontinuing oral antidiabetic medications without healthcare provider guidance can lead to uncontrolled blood glucose levels.

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