Nursing Elites

1. What is the significance of patient advocacy in nursing?

• A. Prioritizing the needs of the healthcare team over the patient
• B. Ensuring that patients' rights and preferences are respected
• C. Limiting patient autonomy
• D. Focusing solely on clinical procedures

Correct answer: B

Rationale: Patient advocacy in nursing entails ensuring that patients' rights and preferences are respected. This involves advocating for the patients' best interests, supporting informed decision-making, and safeguarding their autonomy. Choice A is incorrect because patient advocacy focuses on the patient's needs, not the healthcare team's. Choice C is incorrect as patient advocacy aims to empower patients and enhance their autonomy rather than limiting it. Choice D is incorrect since patient advocacy goes beyond clinical procedures to encompass holistic care that addresses the patients' preferences and rights.

2. The doctor has ordered 1,000 cc of intravenous fluid every 8 hours. You will be using intravenous tubing that delivers 20 cc/drop. At what rate will you adjust the intravenous fluid flow? _____ gtts per minute.

• A. 38 gtts/min
• B. 42 gtts/min
• C. 50 gtts/min
• D. 40 gtts/min

Correct answer: D

Rationale: To calculate the rate: 1000 cc/8 hours = 125 cc/hour. 125 cc/hour * 1 drop/20 cc * 1 hour/60 minutes = 40 gtts/min. Therefore, the correct answer is 40 gtts/min. Choice A (38 gtts/min) is incorrect as it doesn't match the calculation result. Choice B (42 gtts/min) is incorrect as it is not the calculated rate. Choice C (50 gtts/min) is incorrect as it is not the calculated rate either.

3. What is the most common cause of HHNS?

• A. Insulin overdose
• B. Removal of the adrenal gland
• C. Undiagnosed, untreated hyperpituitarism
• D. Undiagnosed, untreated diabetes mellitus

Correct answer: D

Rationale: The correct answer is D: Undiagnosed, untreated diabetes mellitus. Hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is most commonly caused by undiagnosed and untreated diabetes mellitus. Insulin overdose (Choice A) is not a typical cause of HHNS; it is more related to hypoglycemia. Removal of the adrenal gland (Choice B) can lead to adrenal insufficiency but is not a common cause of HHNS. Undiagnosed, untreated hyperpituitarism (Choice C) is not a usual cause of HHNS; it is more related to pituitary hormone imbalances rather than hyperglycemia.

4. While administering penicillin intravenously, you notice that the patient becomes hypotensive with a bounding, rapid pulse rate. What is the first action you should take?

• A. Decrease the rate of the intravenous medication flow.
• B. Increase the rate of the intravenous medication flow.
• C. Call the doctor.
• D. Stop the intravenous flow.

Correct answer: D

Rationale: The correct action to take when a patient becomes hypotensive with a bounding, rapid pulse rate after administering penicillin intravenously is to stop the intravenous flow immediately. This can help prevent further complications by discontinuing the administration of the medication that might be causing the adverse effects. Decreasing or increasing the rate of medication flow may not address the underlying issue of the patient's adverse reaction. While it's important to involve the healthcare provider in such situations, the immediate priority is to halt the administration of the medication.

5. Which of the following nursing interventions should be taken for a client who complains of nausea and vomits one hour after taking his glyburide (DiaBeta)?

• A. Administer glyburide again
• B. Administer subcutaneous insulin and monitor blood glucose
• C. Monitor blood glucose closely, and look for signs of hypoglycemia
• D. Monitor blood glucose and assess for signs of hyperglycemia

Correct answer: C

Rationale: After a client complains of nausea and vomits one hour after taking glyburide, the priority nursing intervention should be to monitor blood glucose closely and look for signs of hypoglycemia. Vomiting could indicate that the glyburide was not properly absorbed, potentially leading to hypoglycemia. Administering glyburide again (Choice A) could worsen hypoglycemia. Administering subcutaneous insulin (Choice B) is not appropriate without assessing the blood glucose first. Monitoring for signs of hyperglycemia (Choice D) is not the immediate concern in this situation.

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