Nursing Elites

1. A healthcare professional is reading a physician's progress notes in the client's record and reads that the physician has documented 'insensible fluid loss of approximately 800 mL daily.' The healthcare professional understands that this type of fluid loss can occur through:

• A. The skin
• B. Urinary output
• C. Wound drainage
• D. The gastrointestinal tract

Correct answer: A

Rationale: Insensible fluid loss refers to the fluid lost from the body that is not easily measured, such as through sweating and respiration. The skin is a major contributor to insensible fluid loss due to evaporation of water through the skin. Choice B, urinary output, represents measurable fluid loss through urine excretion. Choice C, wound drainage, is a measurable form of fluid loss that occurs externally from a wound. Choice D, the gastrointestinal tract, primarily involves fluid loss through feces and is also a measurable form of output. Therefore, the correct answer is 'A: The skin,' as it is the main route for insensible fluid loss.

2. During a class on exercise for diabetic clients, a female client asks the nurse educator how often to exercise. The nurse educator advises the clients to exercise how often to meet the goals of planned exercise?

• A. At least once a week
• B. At least three times a week
• C. At least five times a week
• D. Every day

Correct answer: C

Rationale: Exercising at least five times a week is recommended to meet the goals of planned exercise for diabetic clients. This frequency helps in managing blood sugar levels effectively and improving overall health. Exercising once a week (Choice A) may not provide sufficient benefits or consistency required for diabetic clients. Exercising three times a week (Choice B) is better but may still fall short of the recommended frequency for optimal outcomes. Exercising every day (Choice D) may lead to burnout or overtraining if not properly balanced with rest days, which could be counterproductive for diabetic clients.

3. A client with type 1 diabetes mellitus is experiencing hypoglycemia. What should the nurse instruct the client to do?

• A. Administer insulin immediately
• B. Consume 15 grams of simple carbohydrates
• C. Drink plenty of water
• D. Avoid eating until symptoms resolve

Correct answer: B

Rationale: When a client with type 1 diabetes mellitus experiences hypoglycemia, the nurse should instruct them to consume 15 grams of simple carbohydrates. This is the recommended initial treatment for hypoglycemia as it helps quickly raise blood sugar levels to alleviate symptoms and prevent complications. Administering insulin immediately (Choice A) would further lower blood sugar levels, worsening the hypoglycemia. Drinking plenty of water (Choice C) and avoiding eating until symptoms resolve (Choice D) are not appropriate actions for treating hypoglycemia as they do not address the immediate need to raise blood sugar levels.

4. Scientific management and human relations-based approach are two major theoretical management schools of thought. Which of the following best describes the scientific model of management?

• A. A nurse manager considers methods of motivating the staff to do their assigned tasks.
• B. A nurse manager commends staff for the work they do, reminding them of the importance of their work and the lives they have saved.
• C. A nurse manager analyzes the role of each staff member on the unit to determine ways to increase efficiency.
• D. A conflict between two staff nurses has impacted an entire unit. The unit manager meets with the nurses and entire staff to promote mutual understanding.

Correct answer: C

Rationale: The correct answer is C because scientific management focuses on improving efficiency through the analysis of tasks and work processes. Choice A is more aligned with a human relations-based approach, which emphasizes motivation and relationships. Choice B reflects recognition and morale boosting, which is also characteristic of the human relations approach. Choice D involves conflict resolution and promoting mutual understanding, which is related to the human relations approach rather than scientific management.

5. A female adult client with a history of chronic hyperparathyroidism admits to being noncompliant. Based on initial assessment findings, the nurse formulates the nursing diagnosis of Risk for injury. To complete the nursing diagnosis statement for this client, which 'related-to' phrase should the nurse add?

• A. Related to bone demineralization resulting in pathologic fractures
• B. Related to exhaustion secondary to an accelerated metabolic rate
• C. Related to edema and dry skin secondary to fluid infiltration into the interstitial spaces
• D. Related to tetany secondary to a decreased serum calcium level

Correct answer: A

Rationale: The correct answer is A: 'Related to bone demineralization resulting in pathologic fractures.' In chronic hyperparathyroidism, bone demineralization occurs due to the excessive release of parathyroid hormone, leading to increased calcium resorption from bones. This process weakens the bones, making the client prone to pathologic fractures. Choices B, C, and D are incorrect because they do not directly relate to the increased risk of injury associated with chronic hyperparathyroidism. Exhaustion, edema, dry skin, and tetany are not the primary risks for injury in this client population.

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