Nursing Elites

1. In which position will you place your patient when they are demonstrating the signs and symptoms of hypovolemic shock?

• A. The Trendelenburg position
• B. The supine position
• C. The left lateral position
• D. The right lateral position

Correct answer: A

Rationale: The correct answer is A, the Trendelenburg position. This position involves placing the patient with their legs elevated higher than their head. It is used to increase blood flow to the upper body, including the brain and heart, in cases of hypovolemic shock. This helps improve perfusion to vital organs. Choices B, C, and D are incorrect as they do not facilitate the desired redistribution of blood flow needed in hypovolemic shock. The supine position is lying flat on the back, the left lateral position is lying on the left side, and the right lateral position is lying on the right side.

2. A nurse is caring for a client who is unconscious and whose partner is their health care surrogate. The partner wishes to discontinue the client's feeding tube, but another family member tells the nurse that they want the client to continue receiving treatment. Which of the following responses should the nurse make?

• A. You should contact the provider about your wishes for your family member.
• B. We'll need to have the nursing supervisor review the client's advance directives.
• C. You should speak with the facility's ethics committee about your concerns.
• D. As the health care surrogate, the client's partner can make this decision.

Correct answer: D

Rationale: The correct response is D because the health care surrogate, as designated by the client, has the legal authority to make healthcare decisions on behalf of the client when they are unable to do so. This authority includes decisions about treatment continuation or withdrawal. Option A is incorrect as the family member's wishes do not override the legal authority of the health care surrogate. Option B is not the most appropriate action in this situation as the advance directives are already clear by the designation of a health care surrogate. Option C is not necessary at this stage since the health care surrogate can make the decision without involving the ethics committee.

3. Which of the following is true regarding the Affordable Care Act?

• A. The Affordable Care Act addressed issues of interest to nursing without controversy.
• B. The Affordable Care Act addressed issues of mandatory overtime, incivility, and high workloads for nurses.
• C. The Affordable Care Act provided a new patient-centered model for health care.
• D. The Affordable Care Act attempted to address many of the issues of interest to nursing, but came with much controversy.

Correct answer: D

Rationale: The correct answer is D. The Affordable Care Act attempted to address many issues relevant to nursing, such as mandatory overtime, incivility, and high workloads, but it faced significant controversy. Choice A is incorrect as the act did not address nursing issues without controversy. Choice B is incorrect as it inaccurately lists the issues the act addressed. Choice C is incorrect as it does not fully capture the controversy surrounding the Affordable Care Act.

4. What does the mnemonic device ABCDE stand for?

• A. Allergy, bleeding, chemicals, dietary, environment
• B. Allergy, bleeding, cardio, diabetes, endocrine
• C. Allergy, bleeding, cardio, digestive, endocrine
• D. Allergy, bleeding, cortisone, diabetes, emboli

Correct answer: D

Rationale: The correct answer is D: 'Allergy, bleeding, cortisone, diabetes, emboli.' The ABCDE mnemonic is used in healthcare to help remember key assessment points. Choice A is incorrect as 'chemicals' and 'dietary' are not part of the ABCDE assessment. Choice B is incorrect as 'cardio' is not part of the ABCDE mnemonic. Choice C is incorrect as 'cardio' and 'digestive' are not part of the ABCDE mnemonic.

5. Nurse Andy has finished teaching a client with diabetes mellitus how to administer insulin. He evaluates the learning has occurred when the client makes which statement?

• A. I should check my blood sugar immediately prior to the administration.
• B. I should provide direct pressure over the site following the injection.
• C. I should use the abdominal area only for insulin injections.
• D. I should only use a calibrated insulin syringe for the injections.

Correct answer: D

Rationale: The correct answer is D because using a calibrated insulin syringe is crucial for accurate dosing when administering insulin. Choice A is incorrect because checking blood sugar before administration is essential but not the specific evaluation of learning in this context. Choice B is incorrect as applying direct pressure over the injection site is not a key indicator of learning about insulin administration. Choice C is incorrect as insulin injections can also be administered in other sites like the thigh or arm; it is not limited to the abdominal area.

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