Nursing Elites

1. A client with a tumor refuses surgery, but the client's partner wants it. Which is the deciding factor in determining if the surgery will be done?

• A. Whether the partner is the client's durable power of attorney for healthcare
• B. Whether the client understands the risk of refusing the procedure
• C. Whether the client's refusal is based on religious belief
• D. Whether the facility's ethical committee reaches a consensus on the case

Correct answer: B

Rationale: The correct answer is B because the client's understanding of the risks involved in refusing the surgery is crucial in determining the course of action. In this scenario, the client's autonomy and decision-making capacity take precedence. Choice A is not directly relevant to the decision-making process regarding surgery. Choice C, religious beliefs, may influence the decision but should not be the determining factor in this case. Choice D involving the facility's ethical committee is not typically involved in individual patient care decisions.

2. What is the softening and thinning of the cervix during labor known as?

• A. Dilation
• B. Symphysis
• C. Effacement
• D. Hyperplasia

Correct answer: C

Rationale: Effacement is the correct term for the softening and thinning of the cervix during labor. It is the process where the cervix becomes thinner, allowing it to stretch and open as labor progresses. Choice A, 'Dilation,' is incorrect as it refers to the opening of the cervix. Choice B, 'Symphysis,' is incorrect as it refers to the joint that connects the two pubic bones. Choice D, 'Hyperplasia,' is incorrect as it refers to an increase in the number of cells in an organ or tissue.

3. Which nonpharmacological technique involves the use of electronic monitoring equipment while the patient controls basic bodily mechanisms?

• A. Meditation
• B. Visualization
• C. Biofeedback
• D. Chiropractic

Correct answer: C

Rationale: The correct answer is C: Biofeedback. Biofeedback is a nonpharmacological technique that uses electronic monitoring equipment to provide real-time data on physiological processes such as heart rate, muscle tension, and skin temperature. Through this feedback, patients learn to control and regulate these bodily functions voluntarily. Choice A, Meditation, involves focusing the mind and reducing stress through techniques like mindfulness or deep breathing, but it does not specifically rely on electronic monitoring equipment. Choice B, Visualization, is a technique where individuals imagine peaceful scenes to promote relaxation and reduce anxiety, and it also does not involve electronic monitoring. Choice D, Chiropractic, is a healthcare profession that focuses on the diagnosis and treatment of musculoskeletal disorders through manual adjustments and manipulation, which is unrelated to the use of electronic monitoring equipment for controlling bodily functions.

4. The doctor has ordered 20 cc per hour of normal saline intravenously for your pediatric patient. You will be using pediatric intravenous tubing that delivers 60 cc per drop. How many drops per minute will you administer using this pediatric intravenous set?

• A. 30 drops per minute
• B. 25 drops per minute
• C. 20 drops per minute
• D. 22 drops per minute

Correct answer: C

Rationale: To calculate the drops per minute, first convert the ordered amount to drops per minute. 20 cc per hour equals 20 drops per hour with 60 cc per drop tubing, which is equivalent to 20 drops per hour * 60 cc per drop = 1200 drops per hour. To find drops per minute, divide 1200 by 60 (minutes in an hour), which equals 20 drops per minute. Therefore, the correct answer is 20 drops per minute. Choices A, B, and D are incorrect as they do not reflect the correct calculation based on the provided information.

5. Which of the following methods of insulin administration would be used in the initial treatment of hyperglycemia in a client with diabetic ketoacidosis?

• A. Subcutaneous
• B. Intramuscular
• C. IV bolus only
• D. IV bolus, followed by continuous infusion

Correct answer: D

Rationale: The correct answer is D: IV bolus, followed by continuous infusion. In the initial treatment of hyperglycemia in a client with diabetic ketoacidosis, insulin is administered via IV bolus to quickly reduce blood glucose levels, followed by a continuous infusion to maintain control. Subcutaneous and intramuscular routes are not used in this situation as they are not rapid or predictable enough to address the acute hyperglycemia seen in diabetic ketoacidosis. IV bolus alone without the continuous infusion may not provide sustained control of blood glucose levels, making choice C incorrect.

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