Nursing Elites

1. A client is preparing advance directives. Which of the following statements by the client indicates an understanding of advance directives?

• A. I cannot change my instructions once I have signed them.
• B. My doctor will need to approve my advance directives.
• C. I need a witness to sign my advance directives.
• D. I have the right to refuse treatment.

Correct answer: D

Rationale: The correct answer is D: 'I have the right to refuse treatment.' This statement shows an understanding of advance directives because they allow individuals to specify their treatment preferences in advance, including the right to refuse treatment. Choices A, B, and C are incorrect. Choice A is inaccurate as individuals can update or change their advance directives at any time. Choice B is incorrect because while a doctor may discuss advance directives with the client, approval is not required for the directives to be valid. Choice C is also incorrect as a witness is typically required to verify the client's signature, not the other way around.

2. A nurse is preparing to teach a client about the use of a peak flow meter. Which of the following instructions should the nurse include?

• A. Place the mouthpiece in your mouth and blow out as quickly as you can.
• B. Exhale slowly into the mouthpiece over 5 seconds.
• C. Take a slow deep breath before blowing into the mouthpiece.
• D. Blow into the mouthpiece at a steady rate for 3 seconds.

Correct answer: A

Rationale: The correct instruction for using a peak flow meter is to place the mouthpiece in your mouth and blow out as quickly as you can. This action helps measure the peak expiratory flow of the client. Choice B is incorrect because exhaling slowly does not provide an accurate peak flow reading. Choice C is incorrect as taking a slow deep breath before blowing interferes with obtaining an accurate measurement. Choice D is incorrect as blowing at a steady rate for 3 seconds may not reflect the peak expiratory flow accurately.

3. A nurse in a provider's office is reviewing the laboratory results of a group of clients. Which result is reportable?

• A. Herpes simplex
• B. Human papillomavirus
• C. Candidiasis
• D. Chlamydia

Correct answer: D

Rationale: Chlamydia is a reportable sexually transmitted infection. Reporting cases of Chlamydia to the health department is crucial for disease surveillance, contact tracing, and implementing public health interventions. Herpes simplex, human papillomavirus, and candidiasis are not typically reportable infections, as they do not pose the same public health risks as Chlamydia.

4. A nurse is assessing a client who has dehydration. Which of the following findings should the nurse expect?

• A. Bradycardia.
• B. Increased skin turgor.
• C. Tachycardia.
• D. Bounding pulse.

Correct answer: C

Rationale: The correct answer is C: Tachycardia. Tachycardia is a common sign of dehydration because the body tries to compensate for the reduced fluid volume by increasing the heart rate. Bradycardia (choice A) is not typically seen in dehydration as the body tries to maintain perfusion. Increased skin turgor (choice B) is actually a sign of dehydration, but tachycardia is a more specific finding. A bounding pulse (choice D) is associated with conditions like hyperthyroidism or aortic regurgitation, not dehydration.

5. A healthcare professional is preparing to administer an IV fluid bolus of 500 mL over 4 hours to a client who is dehydrated. The healthcare professional should set the IV pump to deliver how many mL/hr?

• A. 75 mL/hr.
• B. 100 mL/hr.
• C. 125 mL/hr.
• D. 150 mL/hr.

Correct answer: C

Rationale: Setting the IV pump to 125 mL/hr ensures the correct infusion rate for delivering 500 mL over 4 hours. To calculate the mL/hr rate, divide the total volume to be infused (500 mL) by the total time for infusion (4 hours): 500 mL / 4 hours = 125 mL/hr. Choice A (75 mL/hr) is too low and would result in an insufficient infusion rate, potentially delaying fluid resuscitation. Choice B (100 mL/hr) would also be too low and not deliver the fluid within the specified time frame. Choice D (150 mL/hr) is too high and would infuse the fluid too quickly, potentially causing fluid overload and complications.

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