Nursing Elites

1. The nurse is teaching the client diagnosed with Type 2 diabetes mellitus about diet. Which diet selection indicates the client understands the teaching?

• A. A submarine sandwich, potato chips, and diet cola
• B. Four (4) slices of a supreme thin-crust pizza and milk
• C. Smoked turkey sandwich, celery sticks, and unsweetened tea
• D. A roast beef sandwich, fried onion rings, and a cola

Correct answer: C

Rationale: The correct answer is C because a smoked turkey sandwich with celery sticks and unsweetened tea is a healthier option for someone with Type 2 diabetes mellitus. Turkey is a lean protein source, celery sticks are low in calories and carbs, and unsweetened tea is a better choice than sugary beverages. Choices A, B, and D are incorrect. Choice A includes high-carb and high-sugar items like potato chips and diet cola, which are not ideal for diabetes management. Choice B contains a high-carb pizza and milk, which may not be suitable for controlling blood sugar levels. Choice D includes fried onion rings and cola, which are high in unhealthy fats and sugars, making it a poor choice for a diabetic diet.

2. The nurse is analyzing laboratory values for the assigned clients. Which finding, based on the client's medical history, indicates the need for immediate follow-up?

• A. Client with chronic kidney disease and serum creatinine of 1.6 mg/dL
• B. Client with diabetes mellitus and a glycosylated hemoglobin A1c (HbA1c) of 7.0%
• C. Client with heart failure and a B-type natriuretic peptide (BNP) of 140 pg/mL
• D. Client who is male and has anemia with hemoglobin of 16.5 g/dL and hematocrit of 45%

Correct answer: B

Rationale: An HbA1c of 7.0% in a client with diabetes mellitus indicates poor long-term glucose control, necessitating immediate follow-up. Choice A, chronic kidney disease with a serum creatinine of 1.6 mg/dL, though concerning, does not indicate an immediate need for follow-up. Choice C, heart failure with a BNP of 140 pg/mL, may require monitoring but not immediate follow-up. Choice D, a male client with anemia and normal hemoglobin and hematocrit levels, does not warrant immediate attention based on the provided information.

3. The medical C4I headquarters has automated data processing systems that aid in which of the following?

• A. Patient accountability
• B. Tracking the movement of patients
• C. Management of health service logistics systems
• D. Patient accountability, tracking the movement of patients, and management of health service logistics systems

Correct answer: D

Rationale: The correct answer is D because the automated data processing systems in the medical C4I headquarters play a role in patient accountability, tracking the movement of patients, and managing health service logistics systems. These systems help in efficiently managing patient information, monitoring and coordinating patient movements, and optimizing the logistics involved in health services. Choices A, B, and C are incorrect because they represent individual aspects that are all encompassed by the functions of the automated data processing systems in the C4I headquarters.

4. A client with type 1 diabetes is diagnosed with diabetic ketoacidosis and initially treated with intravenous fluids followed by an IV bolus of regular insulin. The nurse anticipates that the practitioner will prescribe a continuous infusion of insulin of:

• A. Novolin L insulin
• B. Novolin R insulin
• C. Novolin N insulin
• D. Novolin U insulin

Correct answer: B

Rationale: The correct answer is Novolin R (Regular insulin) because it is used for continuous infusion to treat diabetic ketoacidosis. Novolin R has a rapid onset of action, making it suitable for this acute situation. Novolin L insulin (Choice A) is not typically used for continuous infusion in diabetic ketoacidosis. Novolin N insulin (Choice C) is an intermediate-acting insulin and is not ideal for rapid correction needed in diabetic ketoacidosis. Novolin U insulin (Choice D) is an ultra-long-acting insulin and is not appropriate for the immediate correction required in this scenario.

5. In patients with heart failure, which type of diet is most recommended?

• A. High-sodium
• B. Low-sodium
• C. High-fat
• D. Low-carbohydrate

Correct answer: B

Rationale: A low-sodium diet is most recommended for patients with heart failure. This type of diet helps manage fluid retention by reducing the amount of sodium in the body, which in turn decreases the workload on the heart. High-sodium diets can lead to fluid retention and worsen heart failure symptoms. High-fat and low-carbohydrate diets are not specifically recommended for heart failure patients as the focus is primarily on controlling sodium intake.

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