Nursing Elites

1. What is the fundamental difference between nursing diagnoses and collaborative problems?

• A. Collaborative problems are managed by nurses using physician-prescribed interventions.
• B. Collaborative problems can be addressed by independent nursing interventions.
• C. Physician-prescribed interventions are incorporated into nursing diagnoses.
• D. Nursing diagnoses include physiologic complications that nurses monitor to detect status changes.

Correct answer: B

Rationale: The correct answer is B, as collaborative problems necessitate the collective expertise and skills of numerous healthcare professionals, including nurses. These problems can be dealt with through independent nursing interventions in cooperation with other team members. Option A is incorrect because collaborative problems aren't strictly managed with physician-prescribed interventions. Option C is incorrect because nursing diagnoses aim at identifying and treating actual or potential health issues, rather than merely integrating physician-prescribed interventions. Option D is incorrect because nursing diagnoses aim at identifying patient issues, not solely physiologic complications, and guide the necessary nursing care, not just monitor for changes.

2. A nurse is caring for a client who is receiving parenteral nutrition. Which of the following findings indicates the therapy is effective?

• A. Client has soft, formed bowel movements.
• B. Client’s mucous membranes are pink.
• C. Client reports ability to complete ADLs.
• D. Client’s blood glucose level is within the expected reference range.

Correct answer: D

Rationale: The correct answer is D because having a blood glucose level within the expected reference range indicates that parenteral nutrition is effectively meeting the client's nutritional needs. Choices A, B, and C are incorrect because soft, formed bowel movements, pink mucous membranes, and the ability to complete activities of daily living do not directly reflect the effectiveness of parenteral nutrition therapy.

3. The nurse understands that one of these factors contributes to constipation:

• A. excessive exercise
• B. high fiber diet
• C. no regular time for defecation daily
• D. prolonged use of laxatives

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

4. Which symptoms are associated with cancer of the colon?

• A. constipation, ascites, and mucus in the stool
• B. diarrhea, heartburn, and eructation
• C. blood in the stools, anemia, and 'pencil-shaped' stools
• D. anorexia, hematemesis, and increased peristalsis

Correct answer: C

Rationale: The correct symptoms associated with cancer of the colon are blood in the stools, anemia, and 'pencil-shaped' stools. These symptoms are classic indicators of colorectal cancer. Choices A, B, and D do not typically present in colorectal cancer. Constipation, ascites, and mucus in the stool are more commonly associated with other gastrointestinal conditions. Diarrhea, heartburn, and eructation are not typical symptoms of colon cancer. Anorexia, hematemesis, and increased peristalsis are more indicative of other gastrointestinal issues and not specific to colon cancer.

5. Which of the following is reflected in an ECG due to hypokalemia?

• A. Tall T waves and Pathologic Q wave
• B. Widening QRS Complex and U wave
• C. None of the above
• D. Both A and B

Correct answer: B

Rationale: Hypokalemia, a condition characterized by low levels of potassium in the blood, is reflected in an ECG by a widening QRS Complex and a U wave. This is because potassium plays a key role in the electrical activity of the heart, and its deficiency can lead to abnormalities in the heart's rhythm as represented by these specific changes on the ECG. Choice A is incorrect as tall T waves and pathologic Q waves are more commonly associated with hyperkalemia or myocardial infarction, respectively, rather than hypokalemia. Choices C and D are also incorrect as they do not accurately reflect the ECG changes caused by hypokalemia.

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