Nursing Elites

1. A healthcare professional is administering 1 L of 0.9% sodium chloride to a client who is postoperative and has fluid volume deficit. Which of the following changes should the healthcare professional identify as an indication that the treatment was successful?

• A. Increase in hematocrit
• B. Increase in respiratory rate
• C. Decrease in heart rate
• D. Decrease in capillary refill time

Correct answer: D

Rationale: The correct answer is D: Decrease in capillary refill time. In a client with fluid volume deficit, improving capillary refill time indicates that the perfusion status is improving due to the increase in fluid volume. Choices A, B, and C are incorrect. An increase in hematocrit may indicate hemoconcentration due to fluid loss, an increase in respiratory rate may suggest respiratory distress, and a decrease in heart rate may not be directly related to fluid volume status.

2. An RN enters a patient�s room to place an indwelling urinary catheter, as ordered by the health-care professional. The client is alert and oriented and tells the RN he wants to leave the hospital now and not receive further treatment. Which of the following actions by the RN would be considered false imprisonment?

• A. The RN tells the client he is not allowed to leave until the physician has released him.
• B. The RN asks the client why he wishes to leave.
• C. The RN asks the client to explain what he understands about his medical diagnosis.
• D. The RN asks the client to sign an against medical advice discharge form.

Correct answer: A

Rationale: The RN tells the client he is not allowed to leave until the physician has released him would be considered false imprisonment.

3. Although technology has seen many advances, which two ethical principles may be in conflict because of technology?

• A. Beneficence and justice
• B. Beneficence and nonmaleficence
• C. Beneficence and veracity
• D. Beneficence and confidentiality

Correct answer: B

Rationale: The correct answer is B: Beneficence and nonmaleficence. Beneficence refers to the obligation to do good and act in the best interest of the patient, while nonmaleficence means to 'do no harm.' With advances in technology, there can be situations where the pursuit of benefit (beneficence) may inadvertently cause harm (nonmaleficence), leading to a conflict between these two ethical principles. Choice A, beneficence and justice, is incorrect because justice pertains to fairness and equality in the distribution of resources and treatments, not conflicting directly with beneficence. Choice C, beneficence and veracity, involves the obligation to tell the truth and is not in direct conflict with beneficence. Choice D, beneficence and confidentiality, relate to maintaining privacy and trust, which can complement rather than conflict with beneficence in most cases.

4. The staff of a medical-surgical unit is in disagreement about holiday scheduling. The nurse manager knows that this is what type of conflict?

• A. Intragroup conflict
• B. Intergroup conflict
• C. Interpersonal conflict
• D. Intrapersonal conflict

Correct answer: A

Rationale: The correct answer is A: Intragroup conflict. Intragroup conflict occurs within one group, in this case, the staff of the medical-surgical unit. Intergroup conflict, on the other hand, happens between two or more groups. Interpersonal conflict involves conflicts between two or more individuals, and intrapersonal conflict is conflict within one individual. Since the disagreement about holiday scheduling involves members within the same group (staff of the medical-surgical unit), it is an example of intragroup conflict. Therefore, the nurse manager would recognize this as an intragroup conflict rather than any of the other types mentioned.

5. The nurse is assessing a 22-year-old patient experiencing the onset of symptoms of type 1 diabetes. Which question is most appropriate for the nurse to ask?

• A. "Are you anorexic?"
• B. "Is your urine dark colored?"
• C. "Have you lost weight lately?"
• D. "Do you crave sugary drinks?"

Correct answer: C

Rationale: Weight loss is a common symptom in the onset of type 1 diabetes due to the body's inability to use glucose for energy. The lack of insulin leads the body to break down fat and muscle for fuel, causing unintentional weight loss. This is a more relevant question compared to the others, as it directly relates to the metabolic changes associated with type 1 diabetes.

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