Nursing Elites

1. Rachel is a 48-year-old mother of three who has been admitted after a drug overdose in a failed suicide attempt. When she regains consciousness, she states that she is ashamed and embarrassed that she tried to take her own life. What is the most therapeutic response to Rachel's statement?

• A. It's a relief your children weren't left without a mother.
• B. What were you thinking?
• C. We're here to help patients who value life.
• D. I know life can be difficult. We're here to help you.

Correct answer: D

Rationale: The most therapeutic response to Rachel's statement is to provide non-judgmental support and hope. By acknowledging the patient's feelings of shame and embarrassment and offering help and understanding, the nurse can help Rachel maintain her self-esteem. Choice A is not therapeutic as it may unintentionally convey guilt or further shame. Choice B is judgmental and confrontational, which can create a barrier to open communication. Choice C is dismissive and does not address Rachel's emotional state. The correct response (Choice D) acknowledges the patient's struggle, offers support, and conveys empathy, aligning with the nurse's role to treat all patients with respect and dignity in challenging situations.

2. Which of the following nursing interventions is appropriate for a client suffering from a fever?

• A. Avoid withholding food from the client
• B. Increase the client's fluid intake
• C. Provide oxygen
• D. All answers are correct

Correct answer: B

Rationale: The appropriate nursing intervention for a client suffering from a fever is to increase the client's fluid intake. A fever can elevate the body's metabolism, leading to increased breathing and heart workload. This can result in fluid loss due to heightened respiration and sweating. Moreover, the augmented heart workload may necessitate more oxygen to maintain tissue perfusion. Providing oxygen and increasing fluid intake help meet the body's heightened demands during a fever. Withholding food from the client is inappropriate as proper nutrition is crucial for recovery, and providing oxygen alone may not address the fluid and metabolic demands associated with fever. Therefore, the correct choice is to increase the client's fluid intake.

3. Which of the following conditions may warrant a serum creatinine level?

• A. Rhabdomyolysis
• B. Digitalis toxicity
• C. Glomerulonephritis
• D. All answers are correct

Correct answer: D

Rationale: A serum creatinine level may be warranted in conditions that can affect renal function or cause muscle breakdown. Rhabdomyolysis, characterized by muscle injury and breakdown, can lead to elevated creatinine levels due to the release of creatinine from muscles. Digitalis toxicity can impair renal function, leading to a need for monitoring creatinine levels. Glomerulonephritis, an inflammatory condition affecting the kidney's filtering units, can also impact renal function and require assessment of creatinine levels. Therefore, all the provided conditions may warrant a serum creatinine level to assess renal function and muscle breakdown.

4. When should discharge training and planning begin for a 65-year-old man admitted to the hospital for spinal stenosis surgery?

• A. Following surgery
• B. Upon admission
• C. Within 48 hours of discharge
• D. Preoperative discussion

Correct answer: B

Rationale: Discharge training and planning should begin upon admission for a patient undergoing spinal stenosis surgery. It is crucial to initiate this process early to ensure a smooth transition from hospital care to home or a rehabilitation facility. Starting discharge planning upon admission allows for comprehensive involvement of the patient, family, and healthcare team, which can reduce the risk of readmission, optimize recovery, ensure proper medication management, and adequately prepare caregivers. Therefore, option B, 'Upon admission,' is the correct answer. Options A, C, and D are incorrect because waiting until after surgery, within 48 hours of discharge, or during preoperative discussion would not provide sufficient time for effective discharge planning and education.

5. A client has volunteered to take part in a research study. After participating for two months, he decides that he can no longer tolerate the study and decides to leave. What are the client's rights in this situation?

• A. The client has a right to be released from the study but must reimburse the researchers for charges incurred
• B. The client has a right to be released from the study without any liability
• C. The client has a right to be released from the study but is prohibited from participating in any future studies
• D. The client does not have the right to be released from the study; he must finish his participation

Correct answer: B

Rationale: When a client voluntarily participates in a research study and later decides to withdraw, they have the right to be released from the study without any liability. It is unethical to force a participant to continue in a study against their will as this violates their autonomy and personal rights. Choice A is incorrect as it suggests that the client must reimburse the researchers for charges incurred, which is not typically the case unless agreed upon beforehand. Choice C is incorrect as there is no standard practice prohibiting a participant from future studies just because they withdrew from a current one. Choice D is incorrect because participants always have the right to withdraw from a research study at any time.

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