Nursing Elites

1. In the context of personality disorders, what is a common characteristic of a client with Borderline Personality Disorder?

• A. A need for admiration and a grandiose view of self-importance
• B. Unlawful actions and lack of empathy
• C. Fear of abandonment and impulsiveness
• D. A disregard for others with manipulative behaviors

Correct answer: C

Rationale: The correct answer is C: Fear of abandonment and impulsiveness. Individuals with Borderline Personality Disorder often exhibit intense fears of abandonment, engage in impulsive behaviors such as self-harm or substance abuse, and struggle with unstable relationships. Choices A, B, and D do not align with the characteristic features commonly associated with Borderline Personality Disorder. A need for admiration and grandiosity (Choice A) is more characteristic of Narcissistic Personality Disorder. Unlawful actions and lack of empathy (Choice B) are more typical of Antisocial Personality Disorder. A disregard for others with manipulative behaviors (Choice D) is often seen in individuals with traits of Histrionic or Antisocial Personality Disorders.

2. A nurse is preparing to administer a blood transfusion. What is the most important action to ensure patient safety?

• A. Check the patient's vital signs every 15 minutes during the transfusion.
• B. Verify the patient's identity with two identifiers before starting the transfusion.
• C. Ensure the blood product is administered within 4 hours of removal from the blood bank.
• D. Ensure the patient has signed the informed consent form.

Correct answer: B

Rationale: The most important action to ensure patient safety when administering a blood transfusion is to verify the patient's identity with two identifiers before starting the transfusion. This step is crucial to prevent transfusion errors, such as giving the blood to the wrong patient. Checking vital signs, ensuring timely administration, and confirming informed consent are also important aspects of blood transfusion safety but verifying the patient's identity is the highest priority to prevent errors.

3. A nurse witnesses a colleague administering the wrong IV solution to a client. What should the nurse do first?

• A. Complete an incident report.
• B. Ask the colleague if they intend to report the error.
• C. Call the healthcare provider to notify them of the error.
• D. Notify the supervisor about the situation.

Correct answer: B

Rationale: The correct first step for the nurse to take in this situation is to ask the colleague if they intend to report the error. It is important to address the error promptly and directly with the colleague involved to ensure that the appropriate actions are taken to correct the mistake and prevent harm to the client. Completing an incident report, calling the healthcare provider, or notifying the supervisor can be done after discussing the error with the colleague. Immediate communication with the colleague directly involved in the error is crucial to address the situation effectively.

4. A patient has a DNR (do-not-resuscitate) order but their family insists on resuscitation if necessary. What should the nurse do?

• A. Follow the family's wishes to resuscitate.
• B. Explain that the nurse must follow the DNR order.
• C. Ask the provider for clarification on the DNR.
• D. Call the ethics committee to discuss the situation.

Correct answer: B

Rationale: The correct answer is B. The nurse must follow the legal DNR order, even if the family insists on resuscitation. Respecting the patient's wishes is crucial in providing ethical care. Choice A is incorrect because the nurse should prioritize the patient's documented wishes over the family's requests. Choice C may cause unnecessary delays in care as the DNR order is a legal document. Choice D is not the initial action to take in this situation; the nurse should first address the conflict between the family's wishes and the patient's DNR order.

5. Which of the following is an adverse effect of Lithium Carbonate that requires client education?

• A. Increased risk of infection
• B. Gastrointestinal distress
• C. Increased white blood cell count
• D. Nausea and vomiting

Correct answer: B

Rationale: The correct answer is B: Gastrointestinal distress. When taking Lithium Carbonate, clients may experience gastrointestinal distress as an adverse effect. It is crucial to educate clients about this potential side effect to help them manage it effectively. Choices A, C, and D are incorrect. Increased risk of infection (Choice A) is not a typical adverse effect of Lithium Carbonate. Similarly, increased white blood cell count (Choice C) is not associated with this medication's adverse effects. Nausea and vomiting (Choice D) are general side effects of many medications but are not specifically attributed to Lithium Carbonate.

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