A nurse is completing an admission assessment for a client who reports vomiting and diarrhea for the past 3 days. Which of the following findings should the nurse expect?

Correct Answer: A

Rationale: The correct answer is A. The elevated blood pressure of 144/82 mm Hg indicates dehydration due to vomiting and diarrhea, leading to hypovolemia. This is a compensatory mechanism by the body to maintain perfusion. Option B, urine specific gravity of 1.03, indicates concentrated urine and dehydration, but not as specific as elevated blood pressure. Option C, neck vein distention, is more indicative of heart failure or fluid overload rather than dehydration. Option D, urine specific gravity of 1.01, indicates diluted urine and is not consistent with dehydration. Therefore, based on the symptoms and the compensatory mechanism of the body, an elevated blood pressure is the most likely finding in a client with vomiting and diarrhea.

Correct Answer: C

Rationale: The correct answer is C: Self-actualization. This level in Maslow's hierarchy is rarely met because it represents the highest level of personal growth and fulfillment, where individuals achieve their full potential and self-realization. Most people do not reach this level as it requires a deep understanding of oneself and a continuous journey of personal development. Esteem (A), Safety (B), and Belongingness (D) are more basic needs that are relatively easier to fulfill compared to self-actualization. These lower levels focus on physical and social needs that are essential for survival and well-being, whereas self-actualization involves achieving one's highest aspirations and inner fulfillment.

Correct Answer: C

Rationale: The primary focus of a patient safety program is to enhance patient satisfaction. This is because the ultimate goal of patient safety initiatives is to ensure that patients receive safe and high-quality care, leading to improved patient experience and satisfaction. By prioritizing patient safety, healthcare providers can build trust with patients, reduce medical errors, and prevent harm. Why other choices are incorrect: A: While reducing healthcare costs may be a positive outcome of a patient safety program, it is not the primary focus. B: Improving clinical outcomes is an important goal of patient safety programs, but it is not the primary focus as patient satisfaction encompasses a broader aspect of care. D: Compliance with regulatory standards is essential, but it is a means to achieve patient safety rather than the primary focus.

Correct Answer: C

Rationale: The correct answer is C: Variance. Variance represents the difference between budgeted and actual revenue or cost. It is a crucial metric in performance evaluation and budget control. Variance analysis helps identify discrepancies and allows for adjustments to be made. Incorrect choices: A: Budget - This is the overall plan or financial blueprint for revenues and costs, not the difference between budgeted and actual amounts. B: Variable - Refers to costs that change in relation to activity levels, not specifically the difference between budgeted and actual amounts. D: Premiums - Relates to additional payments made, not the comparison between budgeted and actual figures.

Correct Answer: C

Rationale: The primary function of discipline is to teach. Discipline aims to guide individuals towards desired behaviors, values, and attitudes through positive reinforcement, correction, and guidance. It involves setting boundaries, providing structure, and helping individuals learn from their mistakes. Punishing (choice A) focuses solely on consequences without teaching alternatives. Evaluation (choice B) assesses performance but doesn't necessarily teach. Ridicule (choice D) is harmful and counterproductive, not a purpose of discipline. In summary, discipline primarily serves to educate and cultivate positive behavior.

Correct Answer: C

Rationale: The correct answer is C: It empowers staff to make decisions. Effective delegation involves assigning tasks and responsibilities to employees while providing them with the authority and autonomy to make decisions within their scope of work. This benefits the organization by empowering staff, improving morale, fostering skill development, and increasing productivity. By delegating effectively, managers can focus on strategic tasks, reduce micromanagement, and promote a culture of trust and collaboration within the team. The other choices are incorrect because: A: It increases the manager's workload - Effective delegation should actually decrease the manager's workload by distributing tasks among team members. B: It allows the manager to make all the decisions - This goes against the concept of delegation, which involves sharing decision-making authority with staff. D: It decreases staff involvement - Effective delegation should increase staff involvement by giving them responsibilities and decision-making power.

Correct Answer: C

Rationale: The correct answer is C because when an ethical dilemma involves two or more equally unpleasant choices, it can be challenging for decision-makers to come to a consensus. This is known as a moral dilemma, where there is no clear right or wrong option, making it difficult to reach an agreement. In such cases, individuals may have strong convictions about different courses of action, leading to a deadlock in decision-making. Incorrect choices: A: One or more of the parties may be able to reconcile their values - This choice suggests that parties can find common ground by adjusting their values, which is not always possible in complex ethical dilemmas. B: The patient’s point of view is recognized as valuable - While recognizing the patient's perspective is important, it may not directly address the core reason why an agreement cannot be reached. D: The institution is unable to honor the patient’s request - This choice focuses on institutional constraints rather than the fundamental nature of ethical dilemmas and decision-making processes.

Correct Answer: B

Rationale: The correct answer is B: How many hours of overtime you will work. Interviewers are primarily interested in your clinical competence, ability to work as a team member, and confidence in your skills. Overtime hours are not typically a deciding factor in selecting a new staff member as it relates more to scheduling and workload management, which can be negotiated after hiring. It is important to focus on demonstrating your skills, teamwork, and confidence during the interview to showcase your suitability for the position.

Correct Answer: B

Rationale: The correct answer is B because a nurse working for two competing healthcare organizations creates a conflict of interest as they may prioritize one organization over the other. This could compromise patient care and violate ethical standards. A: Accepting gifts from a patient may be inappropriate but does not necessarily create a conflict of interest. C: Disclosing patient information without consent is a breach of confidentiality but not specifically a conflict of interest. D: Delegating tasks improperly is a violation of professional standards but does not directly relate to a conflict of interest.