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1. A 26-year-old female with type 1 diabetes develops a sore throat and runny nose after caring for her sick toddler. The patient calls the clinic for advice about her symptoms and a blood glucose level of 210 mg/dL despite taking her usual glargine (Lantus) and lispro (Humalog) insulin. The nurse advises the patient to
- A. use only the lispro insulin until the symptoms are resolved
- B. limit calorie intake until the glucose is less than 120 mg/dL
- C. monitor blood glucose every 4 hours and notify the clinic if it continues to rise
- D. decrease carbohydrate intake until glycosylated hemoglobin is less than 7%
Correct answer: C
Rationale: In this scenario, the nurse should advise the patient to monitor her blood glucose every 4 hours and notify the clinic if it continues to rise. This is important because the patient is experiencing symptoms of an illness (sore throat and runny nose) that can lead to fluctuations in blood glucose levels. By monitoring frequently, any significant rise in blood glucose can be detected early, enabling prompt intervention. Choice A is incorrect because abruptly stopping glargine (Lantus) insulin can lead to uncontrolled blood glucose levels. Choice B is incorrect as limiting calorie intake is not the appropriate immediate action for managing high blood glucose levels. Choice D is also incorrect as adjusting carbohydrate intake based on glycosylated hemoglobin levels is not the immediate action needed in this acute situation.
2. During a physical assessment of adult clients, which of the following techniques should the nurse use?
- A. Use the Face, Legs, Activity, Cry, and Consolability (FLACC) pain rating scale for a client experiencing pain.
- B. Palpate the client's abdomen before auscultating bowel sounds.
- C. Ensure the bladder of the blood pressure cuff surrounds 80% of the client's arm.
- D. Obtain an apical heart rate by auscultating at the third intercostal space to the left of the sternum.
Correct answer: B
Rationale: When performing a physical assessment, it is essential to palpate the client's abdomen before auscultating bowel sounds. This sequence helps prevent altering bowel sound results due to the pressure applied during palpation. Choice A is incorrect because the FLACC pain rating scale is typically used for nonverbal or pediatric clients, not adults. Choice C is incorrect because the bladder of the blood pressure cuff should surround about 80% of the client's arm circumference, not the bladder of the cuff itself. Choice D is incorrect because to obtain an apical heart rate, auscultation should be done at the fifth intercostal space at the midclavicular line, not at the third intercostal space to the left of the sternum.
3. Which of the following statements accurately describes the relationship between ethical principles and laws?
- A. The government enforces ethics.
- B. Laws guide decision making by setting standards.
- C. Ethics are highly detailed.
- D. Ethical principles can serve as the foundation for laws.
Correct answer: D
Rationale: The statement 'Ethical principles can serve as the foundation for laws' is correct. Ethical principles act as a standard for evaluating actions and behaviors. While ethical principles may influence the creation of laws, they are not laws themselves. Choice A is incorrect as ethics are usually upheld through societal norms and personal values rather than government enforcement. Choice B is incorrect because laws do provide standards, but those standards are legal rather than ethical. Choice C is incorrect as ethics are broad guidelines for behavior, not highly detailed rules.
4. The ANA recommends that nursing in the health care organization change its focus. This requires a shift from a technical model to which of the following?
- A. Professional
- B. Industrial
- C. Random
- D. Organized
Correct answer: A
Rationale: The correct answer is A: Professional. The American Nurses Association (ANA) recommends shifting the focus in healthcare organizations from a technical model to a professional model. This change emphasizes the level of nurse competence required to provide quality care. Choice B, Industrial, is incorrect as it does not align with the focus on professionalism in nursing. Choice C, Random, is unrelated to the context of the question. Choice D, Organized, while a positive attribute, is not the specific focus recommended by the ANA for nursing in healthcare organizations.
5. An environment that rewards good __________ is the goal in a work environment.
- A. Performance
- B. Turnover
- C. Strategies
- D. Stress
Correct answer: A
Rationale: An environment that rewards good performance is the goal in a work environment as it promotes productivity and motivation among employees. Rewarding performance leads to improved outcomes and helps in achieving organizational objectives. Choice B, 'Turnover,' is incorrect as turnover refers to the rate at which employees leave an organization, and it is not a goal to be rewarded. Choice C, 'Strategies,' does not directly relate to rewarding good behavior but rather focuses on plans or approaches to achieve goals. Choice D, 'Stress,' is not something that should be rewarded in a work environment; instead, it should be managed and reduced to promote employee well-being.
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