Nursing Elites

1. A healthcare professional is caring for a client who has a sodium level of 125 mEq/L (136 to 145 mEq/L). Which of the following findings should the healthcare professional expect?

• A. Positive Chvostek's sign
• B. Bradycardia
• C. Numbness of the extremities
• D. Abdominal cramping

Correct answer: D

Rationale: A sodium level of 125 mEq/L indicates hyponatremia, which can lead to abdominal cramping. Abdominal cramping is a common symptom of hyponatremia due to an imbalance in electrolytes. While other options like Chvostek's sign, bradycardia, and numbness of the extremities can be associated with other electrolyte imbalances, they are not typically seen with low sodium levels. Chvostek's sign is related to hypocalcemia, bradycardia can be seen in hyperkalemia, and numbness of the extremities can be a symptom of hypocalcemia or hypokalemia, but not directly related to hyponatremia.

2. Which of the following laws govern nursing practice?

• A. Statutory laws
• B. Common law
• C. Administrative laws
• D. Constitutional laws

Correct answer: A

Rationale: Statutory laws are laws created by legislative bodies, such as state legislatures. In the context of nursing practice, statutory laws govern areas like licensure requirements, scope of practice, and professional standards. Common law, choice B, is based on court decisions and precedents, not specifically related to nursing practice. Administrative laws, choice C, deal with regulations set by administrative agencies rather than governing nursing practice directly. Constitutional laws, choice D, pertain to the fundamental principles outlined in a country's constitution and are not specific to regulating nursing practice.

3. As a new graduate employed in a high-volume maternity unit that uses differentiated practice as its staffing model, what can the nurse expect?

• A. Evidence-based practice guides risk management principles.
• B. Client teaching is the responsibility of the team leader.
• C. The initial level of practice responsibility will be limited.
• D. Seniority is the main determinant of client assignments.

Correct answer: C

Rationale: In a differentiated practice model, the scope of nursing practice and responsibility are tailored to different levels of experience. As a new graduate with limited experience, the nurse can expect that the initial level of practice responsibility will be limited to match their skill level and knowledge. This allows for a gradual increase in responsibilities as the nurse gains more experience and expertise. Choice A is incorrect because evidence-based practice is related to clinical decision-making, not the staffing model. Choice B is incorrect as client teaching is typically a shared responsibility among the healthcare team, not solely the team leader's. Choice D is incorrect as differentiated practice models focus on skill level and competence rather than seniority when determining client assignments.

4. Which of the following is used as an indirect estimate of voluntary absenteeism?

• A. Involuntary absenteeism
• B. Voluntary absenteeism
• C. Total time lost
• D. Absence frequency

Correct answer: D

Rationale: The correct answer is 'Absence frequency.' Absence frequency is the total number of distinct absence periods, regardless of duration. It is used as an indirect estimate of voluntary absenteeism because it provides insights into the frequency of absences. Voluntary absenteeism refers to absences that are under the employee's control, while involuntary absenteeism is not under their control. Total time lost, on the other hand, represents the number of scheduled days that employees miss, which is different from absence frequency.

5. What is typically the first sign that a healthcare professional with a substance abuse problem will exhibit?

• A. Avoidance
• B. Bargaining
• C. Denial
• D. Regression

Correct answer: C

Rationale: The correct answer is C: Denial. When healthcare professionals have substance abuse problems, denial is often the initial sign they exhibit. Denial involves minimizing or refusing to acknowledge the issue, making it difficult to recognize and address the substance abuse problem. Choices A, B, and D are incorrect. Avoidance, bargaining, and regression are not typically the first signs displayed by healthcare professionals with substance abuse problems. By identifying denial early on, healthcare professionals can take the necessary steps to seek help and overcome substance abuse issues.

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