Nursing Elites

1. A patient with acute congestive heart failure is receiving high doses of a diuretic. On assessment, the nurse notes flat neck veins, generalized muscle weakness, and diminished deep tendon reflexes. Suspecting hyponatremia, what additional signs would the nurse expect to note in this patient if hyponatremia were present?

• A. Dry skin
• B. Decreased urinary output
• C. Hyperactive bowel sounds
• D. Increased specific gravity of the urine

Correct answer: C

Rationale: In a patient with hyponatremia, hyperactive bowel sounds are expected due to increased gastrointestinal motility. Dry skin (Choice A) is not a typical sign of hyponatremia. Decreased urinary output (Choice B) is more commonly associated with conditions like dehydration or renal issues, not specifically hyponatremia. Increased specific gravity of the urine (Choice D) is a sign of concentrated urine, which is not a characteristic finding in hyponatremia.

2. Which of the following is a primary goal of nursing?

• A. Assist patients in achieving a peaceful death.
• B. Enhance personal knowledge and skills to improve patient outcomes.
• C. Champion quality of life over quantity of life.
• D. Manage costs to enhance patients' quality of life.

Correct answer: A

Rationale: The primary goal of nursing is to assist patients in achieving a peaceful death if recovery is not feasible. This involves providing comfort, dignity, and support during the end-of-life process. Choice B is incorrect because while improving personal knowledge and skills is important, it is not the primary goal of nursing. Choice C, advocating for quality of life over quantity of life, is a valid aspect of nursing care but may not always be the primary goal. Choice D, managing costs to enhance patients' quality of life, is not a primary goal of nursing, as the focus should primarily be on patient care and well-being, rather than financial considerations.

3. Which of the following best defines management?

• A. A manager is someone who ensures that employees complete their work.
• B. A manager controls the work of employees.
• C. A manager organizes and controls a group of employees to get work done.
• D. A manager accomplishes tasks through planning, organizing, commanding, coordinating, and controlling work groups.

Correct answer: D

Rationale: The best definition of management encompasses the comprehensive process of planning, organizing, commanding, coordinating, and controlling work groups to achieve organizational goals. Choice A is too limited, focusing only on ensuring work completion. Choice B is overly restrictive as management involves more than mere control. Choice C is more specific than the correct answer, which encompasses a broader range of managerial functions.

4. A male client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate?

• A. Infusing I.V. fluids rapidly as ordered
• B. Encouraging increased oral intake
• C. Restricting fluids
• D. Administering glucose-containing I.V. fluids as ordered

Correct answer: C

Rationale: The correct nursing intervention for a male client with SIADH is to restrict fluids. In SIADH, there is excess release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. Restricting fluids helps prevent further dilutional hyponatremia by reducing water intake. Infusing I.V. fluids rapidly (choice A) would worsen the condition by adding more fluids, encouraging increased oral intake (choice B) is contraindicated as it adds more fluids, and administering glucose-containing I.V. fluids (choice D) is not a standard treatment for SIADH.

5. Which of the following is true about nursing ethics?

• A. Nursing ethics focus on the organizational level at the workplace.
• B. Nursing ethics focus on the moral character of nurses.
• C. Nursing ethics focus on the experiences and needs of patients.
• D. Nursing ethics focus on the ethical principles governing healthcare organizations.

Correct answer: B

Rationale: The correct answer is B. Nursing ethics primarily focus on the moral character of nurses, emphasizing principles, values, and virtues that guide their professional conduct. Choice A is incorrect as nursing ethics are more about individual moral decision-making than organizational practices. Choice C is incorrect because while nurses consider patients' experiences and needs, nursing ethics primarily revolve around the nurses themselves. Choice D is incorrect as nursing ethics are centered on the moral obligations and responsibilities of nurses, not specifically on the ethical principles governing healthcare organizations.

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