Nursing Elites

1. Which of the following is expected to be most likely true in the near future?

• A. Quality improvement projects will decline due to cost-cutting measures.
• B. Alternative and complementary approaches will gain acceptance in medical practice.
• C. Care will primarily shift away from the hospital setting.
• D. Increased focus on care transitions will involve nursing.

Correct answer: D

Rationale: In the near future, there will be an increased focus on care transitions involving nursing. This means that nurses will play a crucial role in preparing patients for transitions between different care settings, ensuring continuity and quality of care. Choice A is incorrect because quality improvement projects are essential and are not expected to decline. Choice B is incorrect as alternative and complementary approaches are increasingly being integrated into medical practice. Choice C is incorrect as there is a growing trend towards providing care in community settings and homes, moving away from primarily hospital-based care.

2. How many calories per kilogram does an average full-term infant require when the infant is around 1-2 months old?

• A. 140 calories per kilogram per day
• B. 120 calories per kilogram per day
• C. 100 calories per kilogram per day
• D. 160 calories per kilogram per day

Correct answer: B

Rationale: An average full-term infant requires about 120 calories per kilogram per day at 1-2 months old. This amount is essential for their growth and development during this critical stage. Choices A, C, and D are incorrect as they provide calorie amounts that are either too high or too low for an average full-term infant at 1-2 months old, which could potentially lead to health issues or inadequate nutrition.

3. A nurse is assessing an older adult client who was brought to the emergency department by his son, who reports that the client fell at home. The nurse suspects elder abuse. Which of the following actions should the nurse take?

• A. File an incident report.
• B. Ask the client about his injuries with the son present.
• C. Ask the client's son to go to the waiting area.
• D. Treat and discharge the client

Correct answer: C

Rationale: The correct action for the nurse to take is to ask the client's son to go to the waiting area. This allows the nurse to interview the client independently to assess for signs of elder abuse without the son's potential influence. Filing an incident report may be necessary later but is not the immediate action required. Asking about injuries with the son present could lead to biased responses or intimidation. Treating and discharging the client without addressing the suspicion of elder abuse would neglect the nurse's responsibility to ensure the client's safety.

4. Clients with type 1 diabetes may require which of the following changes to their daily routine during periods of infection?

• A. No change
• B. Less insulin
• C. More insulin
• D. Oral antidiabetic agents

Correct answer: C

Rationale: During periods of infection, clients with type 1 diabetes may require more insulin to manage the increased blood glucose levels caused by stress and illness. Insulin needs often rise during infections due to the body's increased resistance to the effects of insulin. Therefore, increasing insulin doses is crucial to maintain blood glucose control. Choices A, B, and D are incorrect. Option A ('No change') is inaccurate because during infections, insulin requirements typically increase. Option B ('Less insulin') is incorrect as the body's increased insulin resistance during infections usually necessitates higher insulin doses. Option D ('Oral antidiabetic agents') is not suitable for type 1 diabetes management as these medications are primarily used for type 2 diabetes.

5. A nurse in a prenatal clinic is caring for a group of clients. Which of the following clients should the nurse recommend for further evaluation and possible intervention?

• A. A client who is at 28 weeks gestation and has a negative Coombs titer
• B. A client who is 39 weeks of gestation and has a negative contraction stress test
• C. A client who is at 35 weeks of gestation and has a biophysical profile of 6
• D. A client who is at 37 weeks of gestation and has an L/S ratio of 2:1

Correct answer: C

Rationale: A biophysical profile of 6 at 35 weeks of gestation indicates a need for further evaluation and possible intervention. A negative Coombs titer at 28 weeks gestation (Choice A) is within normal limits. A negative contraction stress test at 39 weeks gestation (Choice B) is expected as the pregnancy nears term. An L/S ratio of 2:1 at 37 weeks of gestation (Choice D) is consistent with fetal lung maturity.

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