Nursing Elites

1. Which nursing diagnosis is commonly used among patients affected by fibromyalgia?

• A. Decreased self-care in activities of daily living related to fatigue
• B. Impaired mental functioning related to electrolyte imbalances
• C. Increased vigilance secondary to electrolyte imbalances
• D. At risk for a swallowing disorder related to fibromyalgia

Correct answer: A

Rationale: The correct answer is A: 'Decreased self-care in activities of daily living related to fatigue.' Patients with fibromyalgia commonly experience fatigue, which can lead to decreased ability to perform self-care activities. This nursing diagnosis addresses a direct consequence of fibromyalgia. Choices B, C, and D are incorrect because they do not directly correlate with the common manifestations of fibromyalgia. Impaired mental functioning related to electrolyte imbalances and increased vigilance secondary to electrolyte imbalances are not typical presentations of fibromyalgia. 'At risk for a swallowing disorder related to fibromyalgia' is not a common nursing diagnosis associated with fibromyalgia; swallowing disorders are not a primary symptom of this condition.

2. A nurse is orienting a newly licensed nurse about client confidentiality. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

• A. I can use another nurse's password as long as I log off after using the computer
• B. I should encrypt personal health information when sending emails
• C. I can post the client's vital signs in the client's room
• D. I should discard personal health information documents in the trash before leaving the unit

Correct answer: B

Rationale: The correct answer is B because encrypting personal health information when sending emails is a crucial aspect of maintaining client confidentiality. This process ensures that sensitive information is protected during electronic communication. Choice A is incorrect as sharing passwords violates client confidentiality. Choice C is incorrect as posting client's vital signs breaches confidentiality. Choice D is incorrect as discarding personal health information in the trash can lead to unauthorized access.

3. You are caring for a patient with multiple trauma. Of all of these injuries and conditions, which is the most serious?

• A. A deviated trachea
• B. Gross deformity of a lower extremity
• C. Hematuria
• D. Decreased bowel sounds

Correct answer: A

Rationale: A deviated trachea is the most serious condition among the choices provided. It can indicate a tension pneumothorax, which is a life-threatening emergency requiring immediate intervention to prevent respiratory compromise. Choice B, a gross deformity of a lower extremity, while significant, is not as immediately life-threatening as a deviated trachea. Choice C, hematuria, may indicate kidney injury but is not as acutely life-threatening as a deviated trachea. Choice D, decreased bowel sounds, could indicate abdominal issues, but it is not as urgent or immediately life-threatening as a deviated trachea.

4. Your patient has a blood potassium level of 9.2 mEq/L. What intervention should you anticipate for this patient?

• A. Intravenous potassium supplementation
• B. Intravenous calcium supplementation
• C. Kidney dialysis
• D. Parenteral nutrition

Correct answer: C

Rationale: The correct answer is C: Kidney dialysis. A blood potassium level of 9.2 mEq/L indicates severe hyperkalemia, which can be life-threatening. Kidney dialysis is the most appropriate intervention to rapidly lower potassium levels in this situation. Choice A, intravenous potassium supplementation, would worsen the hyperkalemia. Choice B, intravenous calcium supplementation, is not the primary intervention for hyperkalemia. Choice D, parenteral nutrition, is unrelated to treating hyperkalemia and would not address the immediate concern.

5. A nurse manager is reviewing isolation guidelines with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates understanding of isolation guidelines?

• A. I will have a client who is on airborne precautions wear a mask when out of their room.
• B. I will wear an N95 respirator mask for a client who is on droplet precautions.
• C. I will place a client who has compromised immunity in a negative-pressure airflow room.
• D. I will instruct visitors to wear a mask when visiting a client who is on contact precautions.

Correct answer: A

Rationale: The correct answer is A. Having a client on airborne precautions wear a mask when out of their room is appropriate to prevent the spread of infection. Choice B is incorrect because the healthcare provider, not the client, wears an N95 respirator mask for a client on droplet precautions. Choice C is incorrect because negative-pressure airflow rooms are used for clients with airborne infections, not compromised immunity. Choice D is incorrect because visitors, not clients, should wear a mask when visiting a client on contact precautions.

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