The nurse is caring for a client with congestive heart failure. On assessment, the nurse notes that the client is dyspneic and that crackles are audible on auscultation. The nurse suspects excess fluid volume. What additional signs would the nurse expect to note in this client if excess fluid volume is present?

Correct Answer: C

Rationale: An increase in blood pressure is a common sign of fluid volume excess in clients with congestive heart failure due to the increased amount of fluid in the vascular system. Weight loss (Choice A) is not typically associated with fluid volume excess. Flat neck and hand veins (Choice B) are signs of fluid volume deficit, not excess. A decreased central venous pressure (CVP) (Choice D) is not expected in a client with fluid volume excess.

Correct Answer: C

Rationale: A magnesium level of 1.0 mg/dL can cause a depressed ST segment on the ECG. Magnesium deficiency commonly leads to ST segment depression on an electrocardiogram. Prominent U waves are associated with hypokalemia, prolonged PR interval is seen in conditions like first-degree heart block, and widened QRS complexes are typically related to conditions affecting the conduction system of the heart, such as bundle branch blocks.

Correct Answer: A

Rationale: The correct answer is A: Autonomy. Autonomy is the ethical principle that respects an individual's right to make their own decisions, including the right to refuse treatment. This principle acknowledges the patient's self-governance and independence in making choices about their own healthcare. Choice B, Nonmaleficence, refers to the ethical principle of doing no harm and ensuring patient safety. Choice C, Beneficence, involves promoting the patient's well-being and acting in their best interest. Choice D, Justice, pertains to fairness and equitable distribution of healthcare resources.

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.

Correct Answer: A

Rationale: In nursing leadership and management, effective communication is essential for building strong relationships, fostering trust, and promoting teamwork. Option A, where a unit manager meets with a new nurse to discuss what is going well and areas for improvement, is the correct answer. This approach demonstrates active listening, feedback, and a supportive environment for professional growth and development. It encourages open dialogue, addresses individual needs, and promotes a culture of continuous improvement. Option B is incorrect because simply explaining departmental policy lacks the personal touch and individualized feedback necessary for effective communication and leadership development. Option C is wrong as unveiling new policies after safety events may come across as reactive rather than proactive communication, missing the opportunity for timely feedback and improvement. Option D is also incorrect as discussing safety events with another manager without involving the staff directly impacted fails to address communication gaps at the frontline level. Educationally, understanding the nuances of effective communication in leadership is crucial for nursing professionals to enhance patient care outcomes, team collaboration, and organizational success. By prioritizing open, honest, and constructive communication, nurse leaders can create a positive work environment that empowers staff, promotes learning, and drives continuous quality improvement.