Nursing Elites

1. A 32-year-old patient with diabetes is starting on intensive insulin therapy. Which type of insulin will the nurse discuss using for mealtime coverage?

• A. Lispro (Humalog)
• B. Glargine (Lantus)
• C. Detemir (Levemir)
• D. NPH (Humulin N)

Correct answer: A

Rationale: For mealtime coverage in intensive insulin therapy, rapid-acting insulins like Lispro (Humalog) are used. Lispro has a quick onset of action, making it suitable for covering the rise in blood sugar levels after meals. Glargine (Lantus), Detemir (Levemir), and NPH (Humulin N) are all long-acting insulins and are not appropriate for mealtime coverage as they do not act quickly enough to manage postprandial glucose spikes.

2. Which of the following statements is true regarding nursing ethics?

• A. Nursing ethics focus on the organizational level at the workplace.
• B. Nursing ethics focus on the duties and rules of behavior for professional nurses.
• C. Nursing ethics focus on the moral character of nurses.
• D. Nursing ethics focus on the experiences and needs of nurses.

Correct answer: D

Rationale: Nursing ethics not only focus on the experiences and needs of nurses, but also on the nurses� perceptions of these experiences.

3. The nurse is taking a health history from a 29-year-old pregnant patient at the first prenatal visit. The patient reports no personal history of diabetes but has a parent who is diabetic. Which action will the nurse plan to take first?

• A. Teach the patient about administering regular insulin.
• B. Schedule the patient for a fasting blood glucose level.
• C. Discuss an oral glucose tolerance test for the twenty-fourth week of pregnancy.
• D. Provide teaching about an increased risk for fetal problems with gestational diabetes.

Correct answer: B

Rationale: The correct answer is B. Given the family history of diabetes, the initial action the nurse should take is to schedule the patient for a fasting blood glucose level. This will help in assessing if the patient has developed gestational diabetes. Choice A is incorrect because teaching about administering regular insulin is premature without confirming the diagnosis. Choice C is incorrect as an oral glucose tolerance test is typically done earlier in pregnancy. Choice D is incorrect as discussing fetal problems related to gestational diabetes should come after a confirmed diagnosis.

4. Which question during the assessment of a diabetic patient will help the nurse identify autonomic neuropathy?

• A. �Do you feel bloated after eating?�
• B. �Have you seen any skin changes?�
• C. �Do you need to increase your insulin dosage when you are stressed?�
• D. �Have you noticed any painful new ulcerations or sores on your feet?�

Correct answer: A

Rationale:

5. Which of the following behaviors would be an early warning sign that you are not handling job stress in a healthy way?

• A. Focusing excessively on patient outcomes
• B. Needing to spend more time alone
• C. Juggling work, studies, and family responsibilities
• D. Awakening in the morning feeling unrested

Correct answer: D

Rationale: The correct answer is D. Awakening in the morning feeling unrested can be an early warning sign that you are not handling job stress in a healthy way. This may indicate that the stress is impacting your quality of sleep, which is essential for managing stress and maintaining overall well-being. Choices A, B, and C are not necessarily indicative of unhealthy stress management. Focusing excessively on patient outcomes may show dedication to work, needing to spend more time alone could be a personal preference, and juggling work, studies, and family responsibilities could be a common challenge that many individuals face.

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