Nursing Elites

1. Who is credited with the stages of cognitive development?

• A. Erikson
• B. Piaget
• C. Freud
• D. Lister

Correct answer: B

Rationale: Piaget is indeed credited with the stages of cognitive development. Jean Piaget, a renowned psychologist, proposed a theory of cognitive development that outlines distinct stages through which children develop intellectually. Erikson, Freud, and Lister are not associated with the stages of cognitive development. Erikson is known for his psychosocial stages, Freud for psychosexual stages, and Lister for contributions to the field of medicine.

2. Select the stage of shock that is accurately paired with its characteristic.

• A. The initial stage of shock: Hyperventilation occurs and the blood pH rises.
• B. The compensatory stage of shock: Hypoxia occurs and lactic acid rises.
• C. The progressive stage of shock: Histamine is released; fluid and proteins leak into surrounding tissues and the blood thickens.
• D. The refractory stage of shock: Potassium ions leak out; sodium ions build up, and metabolic acidosis increases.

Correct answer: C

Rationale: The progressive stage of shock is accurately described as the stage where histamine is released, leading to fluid and proteins leaking into surrounding tissues and the blood thickening. In this stage, the body's compensatory mechanisms are overwhelmed, resulting in a cascade of events that worsen the shock state. Choice A is incorrect as hyperventilation and a rise in blood pH are more characteristic of the compensatory stage. Choice B is incorrect as hypoxia and a rise in lactic acid are more typical of the progressive stage. Choice D is incorrect as the described electrolyte imbalances and metabolic acidosis are more aligned with the refractory stage of shock.

3. Which of the following foods enhances the absorption of an iron supplement?

• A. Orange juice
• B. Green beans
• C. Fortified milk
• D. Baked potato

Correct answer: A

Rationale: The correct answer is Orange juice. Orange juice enhances the absorption of an iron supplement due to its high vitamin C content. Vitamin C helps in the absorption of non-heme iron, the type of iron found in plant-based foods and iron supplements. Green beans, fortified milk, and baked potato do not have the same level of vitamin C as orange juice, making them less effective in enhancing iron absorption.

4. Although there is projected to be a small surplus of nurses by 2030, some states will continue to see nursing shortages. Which of the following is the best explanation for this situation?

• A. Healthcare legislation that impacts nursing salaries in some states
• B. Workforce availability
• C. Aging of the baby boomers, resulting in a younger nursing workforce
• D. Population declines

Correct answer: B

Rationale: The best explanation for the continued nursing shortages in some states despite an overall projected surplus by 2030 is workforce availability. This factor directly impacts the number of nurses available in certain regions. Choice A about healthcare legislation affecting nursing salaries does not directly address the availability of nurses. Choice C is incorrect as the aging of the baby boomers would typically imply an older nursing workforce instead of a younger one. Choice D regarding population declines does not necessarily relate to the availability of nurses in specific states.

5. Which of the following methods of insulin administration would be used in the initial treatment of hyperglycemia in a client with diabetic ketoacidosis?

• A. Subcutaneous
• B. Intramuscular
• C. IV bolus only
• D. IV bolus, followed by continuous infusion

Correct answer: D

Rationale: The correct answer is D: IV bolus, followed by continuous infusion. In the initial treatment of hyperglycemia in a client with diabetic ketoacidosis, insulin is administered via IV bolus to quickly reduce blood glucose levels, followed by a continuous infusion to maintain control. Subcutaneous and intramuscular routes are not used in this situation as they are not rapid or predictable enough to address the acute hyperglycemia seen in diabetic ketoacidosis. IV bolus alone without the continuous infusion may not provide sustained control of blood glucose levels, making choice C incorrect.

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