NUAS 130SP Exam 4 Final Review T02 Mount Aloysius College.
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Free NUAS 130SP Exam 4 Final Review T02 Mount Aloysius College. Questions
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Nonmaleficence
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Fidelity
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Beneficence
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Autonomy
Explanation
Correct Answer: D) Autonomy
Autonomy is the ethical principle that upholds a competent client's right to make their own informed decisions about their care, including the right to refuse treatment or medication. Even after thorough education, if the client understands the consequences and still chooses to refuse, the nurse must respect that decision. Overriding the client's choice would be a violation of this fundamental ethical principle.
Nonmaleficence means "do no harm" and refers to the obligation to avoid causing harm to the client — it does not apply to a client's refusal of treatment. Fidelity refers to keeping promises and being loyal and trustworthy to the client. Beneficence means acting in the client's best interest, which may motivate the nurse to educate the client, but it does not override the client's right to refuse.
Explanation
Correct Answer: 125 mL/hr
One liter equals 1000 mL. Divide 1000 mL by 8 hours, which equals 125 mL per hour. This is already a whole number, so no further rounding is needed.
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pH
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PaO2
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HCO3
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PaCO2
Explanation
Correct Answer: A) pH
When interpreting arterial blood gases (ABGs), the first step is always to look at the pH to determine whether the client's condition is acidotic or alkalotic. A pH below 7.35 indicates acidosis, while a pH above 7.45 indicates alkalosis. This establishes the primary disturbance before evaluating the other values to determine the cause and whether compensation is occurring.
PaO2 reflects oxygenation status and is assessed separately from acid-base balance — it does not tell the nurse whether acidosis or alkalosis is present. HCO3 (bicarbonate) is the metabolic component of ABG interpretation and is evaluated after the pH has already been identified as acidotic or alkalotic. PaCO2 is the respiratory component and is also assessed after the pH to help determine whether the primary cause is respiratory or metabolic.
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It is an effective strategy in teaching psychomotor skills.
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It allows for standardized information to be presented to each client.
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It is learner-centered and effective for teaching in the affective and cognitive domains.
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It is an efficient and cost-effective way to impart information, particularly for large groups.
Explanation
Correct Answer: A) It is an effective strategy in teaching psychomotor skills.
Teach-back and demonstration are essential for psychomotor learning, which involves performing physical skills such as insulin administration. This method ensures the client can correctly perform the task and allows the nurse to correct errors immediately.
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Continue with the plan and provide verbal and written information to the client.
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Ignore the client and teach the family the home care information instead.
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Modify the education plan and teach the most important information.
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Postpone implementation of the education plan and assess the client further.
Explanation
Correct Answer: D) Postpone implementation of the education plan and assess the client further.
A client who is pacing, hyperventilating, and nauseated is displaying signs of significant anxiety or physiological distress. A client in this state is not in a condition of readiness to learn, as anxiety impairs concentration, retention, and processing of new information. The nurse's priority is to first address the client's immediate physical and emotional state before proceeding with any education.
Continuing with the teaching plan ignores the client's current distress and would be ineffective and unsafe. Ignoring the client entirely and redirecting to the family bypasses the client's rights and fails to address the underlying problem. While modifying the plan to cover only essential information is closer to appropriate, the client's distress still first needs to be assessed and addressed before any teaching is initiated.
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Does not exhibit skin breakdown as a result of edema during hospitalization
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Maintains intake and output balance over 24 hours
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Does not exhibit dryness or cracking of mucous membrane by the end of the shift
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Holds systolic blood pressure between 100 and 130 mm Hg for 24 hours
Explanation
Correct Answer: B) Maintains intake and output balance over 24 hours
The most direct and measurable indicator of fluid balance is an equal intake and output over a 24-hour period. When the amount of fluid taken in equals the amount excreted, it confirms that the body is maintaining homeostasis and that fluid is neither being retained nor lost in excess. This is the gold standard outcome measure for evaluating fluid balance.
Absence of skin breakdown from edema reflects management of a complication of fluid imbalance but does not directly confirm that fluid balance has been achieved. Absence of dry or cracked mucous membranes indicates the client is not dehydrated but does not confirm overall fluid balance. Maintaining systolic blood pressure within a target range reflects cardiovascular status, which is influenced by many factors beyond fluid balance alone.
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Fidelity
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Morals
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Autonomy
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Nonmaleficence
Explanation
Correct Answer: D) Nonmaleficence
Nonmaleficence is the ethical principle meaning "do no harm." By carefully following the rights of medication administration (right patient, right drug, right dose, right route, right time) and performing the required checks, the nurse is actively working to prevent medication errors and protect the client from harm — a direct demonstration of nonmaleficence in practice.
Fidelity refers to keeping promises and maintaining loyalty and trustworthiness in the nurse-client relationship, not specifically to harm prevention protocols. Morals refer to personal values and beliefs about right and wrong but are not a formal ethical principle applied in clinical practice. Autonomy refers to respecting the client's right to make their own informed decisions, which is unrelated to medication safety checks.
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A potassium level of 2.3 mEq/L
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A sodium level of 160 mEq/L
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A sodium level of 130 mEq/L
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A potassium level of 6.0 mEq/L
Explanation
Correct Answer: B) A sodium level of 160 mEq/L
Hypernatremia is defined as a serum sodium level above 145 mEq/L. A sodium level of 160 mEq/L clearly exceeds this threshold and directly confirms the hypernatremic state. Hypernatremia causes water to shift out of cells due to increased extracellular osmolarity, leading to cellular dehydration with symptoms such as thirst, confusion, and in severe cases, seizures.
A potassium level of 2.3 mEq/L indicates hypokalemia, not hypernatremia — these are separate electrolyte imbalances. A sodium level of 130 mEq/L is below the normal range of 135–145 mEq/L, indicating hyponatremia, which is the opposite condition. A potassium level of 6.0 mEq/L indicates hyperkalemia and is unrelated to sodium levels or hypernatremia.
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ABGs
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Bilateral neck veins
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Serum potassium laboratory value in EHR
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Level of consciousness
Explanation
Correct Answer: C) Serum potassium laboratory value in EHR
Before administering any IV fluid containing potassium, the nurse must verify the client's current serum potassium level in the electronic health record. Potassium is a high-alert electrolyte — administering it to a patient who already has a normal or elevated potassium level can cause dangerous hyperkalemia, leading to life-threatening cardiac dysrhythmias including ventricular fibrillation and cardiac arrest.
ABGs reflect acid-base and oxygenation status and are not the priority assessment before potassium-containing fluids. Bilateral neck vein assessment is relevant for fluid volume status but is not specific to potassium administration safety. Level of consciousness is a general neurological assessment and is not the critical check required before hanging potassium-containing IV fluids.
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"You are practicing under the license of the hospital's insurance."
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"You are practicing under the license of the nurse assigned to the patient."
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"You are expected to perform at the level of a prudent nursing student."
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"You are expected to perform at the level of a professional nurse."
Explanation
Correct Answer: C) "You are expected to perform at the level of a prudent nursing student."
The legal standard of care for a nursing student is that they are held to the same standard as a reasonably prudent nursing student with similar education and training. This means the student is personally accountable for their own actions and omissions in patient care. The instructor's role is to supervise and facilitate learning, not to absorb the student's legal and professional responsibility. Ignorance of previously taught skills does not excuse substandard care.
Stating the student is practicing under the hospital's insurance is legally inaccurate and does not reflect the standard of care framework. Saying the student is practicing under the assigned nurse's license is also incorrect — each individual is accountable for their own practice. Holding the student to the standard of a professional nurse would be unfair, as that is a higher bar than what is legally expected of a student.
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