Nursing Elites

1. Which of the following best describes the concept of shared decision-making in healthcare?

• A. The process by which patients make healthcare decisions on their own
• B. A collaborative process that allows patients and providers to make healthcare decisions together
• C. A method for providers to dictate treatment plans to patients
• D. The use of evidence-based guidelines to make healthcare decisions

Correct answer: B

Rationale: The correct answer is B. Shared decision-making in healthcare involves a collaborative process between patients and providers to make healthcare decisions together. This approach considers the patient's preferences, values, and the best available evidence to reach a decision that aligns with the patient's goals. Choice A is incorrect because shared decision-making does not involve patients making decisions on their own. Choice C is incorrect as it describes a paternalistic approach where providers dictate treatment plans to patients without involving them in the decision-making process. Choice D is incorrect as it refers to the use of evidence-based guidelines, which is important but not the sole focus of shared decision-making.

2. A middle adult client tells the nurse, 'I feel so useless now that my children do not need me anymore.' Which of the following responses should the nurse make?

• A. Validate the client's feelings by saying, 'People in middle adulthood often find satisfaction in nurturing and guiding young people.'
• B. Encourage the client to explore the reasons behind feeling useless.
• C. Reassure the client by saying, 'You should be proud that your children are becoming independent.'
• D. Provide information by saying, 'Most people are happy when their children grow up and leave home.'

Correct answer: A

Rationale: The correct response is to validate the client's feelings by acknowledging that individuals in middle adulthood often derive satisfaction from nurturing and guiding young people. This response shows empathy and understanding towards the client's emotions. Choice B is incorrect because it may come across as dismissive of the client's feelings. Choice C is incorrect as it does not address the client's emotional state and could be perceived as minimizing their concerns. Choice D is incorrect as it generalizes feelings and may not be applicable to the client's specific situation.

3. The nurse has administered 4 oz of orange juice to an alert patient whose blood glucose was 62 mg/dL. Fifteen minutes later, the blood glucose is 67 mg/dL. Which action should the nurse take next?

• A. Give the patient 4 to 6 oz more orange juice.
• B. Administer the PRN glucagon (Glucagon) 1 mg IM.
• C. Have the patient eat some peanut butter with crackers.
• D. Notify the healthcare provider about the hypoglycemia.

Correct answer: A

Rationale: The correct action for the nurse to take next is to give the patient 4 to 6 oz more orange juice. The patient's blood glucose has increased from 62 mg/dL to 67 mg/dL after consuming the initial 4 oz of orange juice, indicating that the treatment is effective. Providing additional orange juice will help further raise the blood glucose levels. Administering glucagon (Choice B) is not necessary as the patient's blood glucose is already rising. Having the patient eat peanut butter with crackers (Choice C) is a slower-acting option compared to orange juice. Notifying the healthcare provider about the hypoglycemia (Choice D) is not needed at this point since the patient's blood glucose is improving.

4. A nurse is caring for a client with a diagnosis of terminal cancer. Which of the following statements by the client should indicate to the nurse that the client is ready to hear information regarding palliative care?

• A. "I am ready to learn about chemotherapy to help cure my cancer."
• B. "I just want you to give me something to get this over with soon."
• C. "I want you to tell me about measures available to keep me comfortable."
• D. "I know that many people have recovered fully from cancer, and so will I."

Correct answer: C

Rationale: Choice C is the correct answer because the client expressing a desire to know about measures available to keep comfortable indicates readiness for palliative care. Palliative care focuses on providing comfort, symptom management, and improving the quality of life for patients with serious illnesses such as terminal cancer. Choices A, B, and D are incorrect. Choice A indicates a desire for chemotherapy to cure the cancer, which does not align with palliative care goals. Choice B expresses a wish to end the situation quickly, which may not be in line with palliative care that focuses on comfort and quality of life. Choice D shows optimism about a full recovery, which may not be realistic for a client with terminal cancer who needs palliative care.

5. Which of the following factors contributes to conflicts in professional nursing today?

• A. Some nurses who had planned to retire but find themselves forced to continue working because of the current economic situation
• B. Balancing state practice acts, codes of ethics, and standards of practice
• C. Advances in technology
• D. Multiple generations in the workforce

Correct answer: D

Rationale: The presence of multiple generations in the nursing workforce today with diverse viewpoints and work styles can lead to conflicts. This diversity in perspectives and approaches may result in disagreements on how tasks should be done or how patient care should be managed. Option A refers to economic factors impacting individual nurses rather than conflicts within the profession. Option B is related to compliance and ethical considerations, not conflicts. Option C, advances in technology, may influence nursing practices but is not directly linked to conflicts among professionals.

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