Nursing Elites

1. Which of the following statements is true regarding ethical principles and laws?

• A. The government enforces ethics.
• B. Laws establish standards that aid in decision-making.
• C. Ethics are highly specific.
• D. Ethical principles can serve as the foundation for laws.

Correct answer: D

Rationale: The correct answer is D. Ethical principles can influence the creation of laws but are not equivalent to laws themselves. Laws are established by governing bodies to provide a framework for society, whereas ethical principles guide individuals' moral conduct. Choice A is incorrect because governments enforce laws, not ethics. Choice B is incorrect as laws set legal standards rather than ethical ones. Choice C is incorrect because ethics are principles that guide behavior but are not necessarily highly specific.

2. A female client with physical findings suggestive of a hyperpituitary condition undergoes an extensive diagnostic workup. Test results reveal a pituitary tumor, necessitating a transsphenoidal hypophysectomy. The evening before the surgery, Nurse Jacob reviews preoperative and postoperative instructions provided to the client earlier. Which postoperative instruction should the nurse emphasize?

• A. You must lie flat for 24 hours after surgery.
• B. You must avoid coughing, sneezing, and blowing your nose.
• C. You must restrict your fluid intake.
• D. You must report ringing in your ears immediately.

Correct answer: B

Rationale: Following a transsphenoidal hypophysectomy, it is crucial to avoid activities such as coughing, sneezing, and blowing the nose to prevent an increase in intracranial pressure or the risk of cerebrospinal fluid leakage. Coughing, sneezing, or nose blowing can strain the surgical site, potentially leading to complications. Lying flat for 24 hours is not typically required after this surgery. Fluid intake should be encouraged to prevent dehydration. Ringing in the ears is not a common complication associated with this type of surgery.

3. A client with hyperthyroidism is prescribed propranolol. The nurse understands that this medication is used to:

• A. Increase metabolism
• B. Reduce anxiety
• C. Decrease heart rate
• D. Increase blood pressure

Correct answer: C

Rationale: Propranolol is a beta-blocker commonly used in the management of hyperthyroidism. It works by blocking the effects of adrenaline, resulting in a decrease in heart rate and blood pressure. Choice A is incorrect because propranolol does not increase metabolism; instead, it may have a mild inhibitory effect. Choice B is incorrect as propranolol is not primarily used to reduce anxiety, although it may have some anxiolytic effects. Choice D is incorrect as propranolol actually decreases blood pressure by blocking the effects of adrenaline on the heart and blood vessels.

4. Which of the following best describes the role of a nurse manager in managing conflict on the unit?

• A. The nurse manager is responsible for identifying the sources of conflict and working with staff members to resolve them in a constructive manner.
• B. The nurse manager is responsible for mediating conflicts between staff members and ensuring that they are resolved in a fair and equitable manner.
• C. The nurse manager is responsible for facilitating communication between staff members and ensuring that conflicts are addressed in a timely manner.
• D. The nurse manager is responsible for providing training and support to staff members to help them develop the skills needed to manage conflict effectively.

Correct answer: A

Rationale: The nurse manager's role in managing conflict involves identifying the sources of conflict and working with staff members to resolve them in a constructive manner. This includes addressing conflicts at their root cause and guiding staff towards effective resolution. Choice B is incorrect as the nurse manager typically does not act as a mediator but rather empowers staff to resolve conflicts themselves. Choice C is incorrect as while facilitating communication is important, it is not the sole responsibility of the nurse manager. Choice D is incorrect as providing training and support for conflict management is part of the role, but the primary responsibility lies in addressing the sources of conflict directly.

5. The client has syndrome of inappropriate antidiuretic hormone (SIADH). Which intervention is most appropriate?

• A. Encourage increased fluid intake
• B. Administer hypertonic saline
• C. Monitor for signs of dehydration
• D. Restrict oral fluids

Correct answer: D

Rationale: The correct intervention for a client with syndrome of inappropriate antidiuretic hormone (SIADH) is to restrict oral fluids. This is because SIADH leads to excessive production of antidiuretic hormone, causing water retention and dilutional hyponatremia. By restricting oral fluids, the nurse helps prevent further water retention and imbalance of electrolytes. Encouraging increased fluid intake (Choice A) would exacerbate the condition by further increasing fluid retention. Administering hypertonic saline (Choice B) is not the primary treatment for SIADH, as it may worsen the imbalance. Monitoring for signs of dehydration (Choice C) is not appropriate since SIADH leads to water retention, not dehydration.

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