Nursing Elites

1. 1. To monitor for complications in a patient with type 2 diabetes, which tests will the nurse in the diabetic clinic schedule at least annually (select one that doesn't apply)?

• A. Blood pressure
• B. Serum creatinine
• C. Chest x-ray
• D. Urine for microalbuminuria

Correct answer: C

Rationale: The correct answer is C: Chest x-ray. While monitoring for complications in a patient with type 2 diabetes, annual tests such as blood pressure measurement, serum creatinine levels, and urine for microalbuminuria are essential. These tests help in assessing kidney function, cardiovascular health, and early signs of kidney damage, which are common complications of diabetes. A chest x-ray is not routinely scheduled annually to monitor for complications related to type 2 diabetes, making it the least applicable option.

2. A recent nursing school graduate is preparing to take the NCLEX. The graduate knows which of the following is true?

• A. Upon graduation from nursing school, she cannot use the title RN.
• B. Because the NCLEX is a national examination, her RN license will allow her to practice in all states and territories of the United States.
• C. If her home state participates in the compact agreement, she may practice in other states participating in the agreement, but should renew her license in her home state.
• D. The RN license is a mandatory license.

Correct answer: C

Rationale: Choice C is correct because if the nurse's home state participates in the compact agreement, she can practice in other states that are part of the agreement, but she must still renew her license in her home state. This is necessary to maintain an active license in her home state. Choice A is incorrect because upon graduation, the nurse can use the title RN if licensed, but it's not automatic. Choice B is incorrect because while the NCLEX is a national exam, the nurse needs to meet individual state requirements for licensure in each state. Choice D is incorrect because an RN license is not permissive but rather a mandatory license to practice nursing.

3. A nurse manager has two out of six staff nurses call in sick for one shift. Because of reduced availability of staff, the manager decides to manage the unit with the three remaining nurses, which keeps the unit at minimal staffing standards. What type of decision-making strategy would this be?

• A. Satisficing
• B. Routine
• C. Adaptive
• D. Rationalizing

Correct answer: A

Rationale: Satisficing is the correct decision-making strategy in this scenario. The nurse manager is not aiming for the best solution but rather choosing an alternative that is good enough given the circumstances of staff shortage. Choice B, Routine, does not apply here as the situation is not part of the manager's regular tasks. Choice C, Adaptive, involves adjusting to new conditions, which is not the primary focus in this scenario. Choice D, Rationalizing, does not fit as the decision made is more about finding an acceptable solution rather than justifying it.

4. A nurse has just inserted a nasogastric (NG) tube for a client. Which of the following findings should the nurse expect to confirm correct tube placement?

• A. The client reports relief of nausea.
• B. The tube aspirate has a pH less than 5.
• C. Bowel sounds are present on auscultation.
• D. An x-ray shows the end of the tube above the pylorus.

Correct answer: A

Rationale: The correct answer is A: The client reports relief of nausea. When the NG tube is correctly placed in the stomach, it can help alleviate feelings of nausea and discomfort. Choice B, a tube aspirate pH less than 5, is incorrect as it indicates gastric placement, not necessarily correct placement. Choice C, bowel sounds on auscultation, and Choice D, visualization of the tube on an x-ray above the pylorus, do not confirm correct NG tube placement; therefore, they are incorrect.

5. A client with frequent tonic-clonic seizures is being admitted. What action should the nurse add to the client's plan of care?

• A. Ensure blankets are placed on all four sides of the bed.
• B. Refrain from using restraints during seizure activity.
• C. Position the client laterally during seizure activity.
• D. Have a tongue depressor available at the client's bedside.

Correct answer: D

Rationale: The correct action the nurse should add to the client's plan of care is to have a tongue depressor available at the client's bedside. This is important during a seizure to prevent the client from biting their tongue. Placing the client laterally helps maintain a clear airway and prevents aspiration, making choice C a good practice during seizure activity. Using restraints during a seizure can cause injuries and should be avoided, making choice B incorrect. Wrapping blankets around all four sides of the bed is unnecessary for seizure management and does not contribute to the client's safety during a seizure, making choice A incorrect.

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