Nursing Elites

1. What is the most appropriate response when a client wants to discontinue dialysis?

• A. Ask the client why they want to discontinue.
• B. Instruct the client to focus on self-care.
• C. Offer to call the provider to cancel dialysis.
• D. Seek clarification and establish understanding.

Correct answer: D

Rationale: When a client expresses the desire to discontinue dialysis, the most appropriate response is to seek clarification and establish understanding. This approach allows the healthcare provider to comprehend the client's concerns, provide support, and engage in a collaborative decision-making process. Choice A, asking the client why they want to discontinue, can be perceived as confrontational and may not effectively address the underlying reasons. Instructing the client to focus on self-care (Choice B) may overlook the client's autonomy and decision-making capacity. Offering to call the provider to cancel dialysis (Choice C) does not actively involve the client in the decision-making process or address their concerns adequately.

2. A nurse in a pediatric clinic is collecting data from a school-age child whose injuries are inconsistent with the parent's stated cause. Which of the following actions should the nurse take?

• A. Provide teaching to the parents
• B. Report suspected abuse to the appropriate agency
• C. Document the injuries and monitor the child
• D. Counsel the parents privately

Correct answer: B

Rationale: In cases where a child's injuries are inconsistent with the parent's stated cause, it raises concerns about possible abuse. The correct action for the nurse in this situation is to report suspected abuse to the appropriate agency. This is a legal and ethical obligation for healthcare professionals when they suspect child abuse. Providing teaching to the parents (Choice A) may not address the immediate safety concerns of the child. Documenting the injuries and monitoring the child (Choice C) is important but reporting suspected abuse takes precedence to ensure the child's safety. Counseling the parents privately (Choice D) may not be effective if abuse is suspected, as the primary focus should be on protecting the child.

3. Which of the following is an early indication that a tracheostomy client requires suctioning?

• A. Bradycardia
• B. Irritability
• C. Hypotension
• D. Decreased respiratory rate

Correct answer: B

Rationale: Irritability is indeed an early sign that a tracheostomy client may require suctioning. When a tracheostomy client becomes irritable, it can indicate that there is a need for suctioning to clear the airway. Bradycardia (choice A) refers to a slow heart rate and is not typically a direct indication for suctioning. Hypotension (choice C) indicates low blood pressure and is not specifically related to the need for suctioning. Decreased respiratory rate (choice D) can be a sign of respiratory distress, but irritability is a more direct and early indication of the need for suctioning in a tracheostomy client.

4. What are the early signs of hypoglycemia in a diabetic patient?

• A. Sweating and trembling
• B. Confusion and irritability
• C. Dizziness and increased heart rate
• D. Nausea and vomiting

Correct answer: A

Rationale: The correct answer is A: 'Sweating and trembling.' These are classic early signs of hypoglycemia in a diabetic patient. Sweating occurs due to the activation of the sympathetic nervous system in response to low blood sugar levels, while trembling is a result of the body's attempt to increase muscle activity to raise blood sugar levels. Confusion and irritability (Choice B) are more advanced signs of hypoglycemia that occur if the condition is not treated promptly. Dizziness and increased heart rate (Choice C) can also occur but are not as specific and early as sweating and trembling. Nausea and vomiting (Choice D) are more commonly associated with other conditions or severe hypoglycemia, rather than being early signs.

5. Which type of infectious diseases are required to be reported to the health department?

• A. Staphylococcus aureus infections, including MRSA
• B. Severe cases of flu-like symptoms
• C. Common colds and non-severe respiratory infections
• D. Only contagious diseases like meningitis

Correct answer: A

Rationale: The correct answer is A: Staphylococcus aureus infections, including MRSA. Severe infections like MRSA are required to be reported to the health department as they pose a significant public health risk. Choices B, C, and D are incorrect because severe flu-like symptoms, common colds, and non-severe respiratory infections, and only contagious diseases like meningitis do not fall under the category of infectious diseases that must be reported to the health department.

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