Nursing Elites

1. A 48-year-old male patient screened for diabetes at a clinic has a fasting plasma glucose level of 120 mg/dL (6.7 mmol/L). The nurse will plan to teach the patient about

• A. self-monitoring of blood glucose
• B. using low doses of regular insulin
• C. lifestyle changes to lower blood glucose
• D. effects of oral hypoglycemic medications

Correct answer: C

Rationale: When a patient has a fasting plasma glucose level of 120 mg/dL (6.7 mmol/L), indicating prediabetes, the initial approach is focused on lifestyle modifications to lower blood glucose levels. These changes may include dietary adjustments, increased physical activity, and weight management. Self-monitoring of blood glucose, insulin therapy, and oral hypoglycemic medications are not typically the first-line interventions for patients with prediabetes. Educating the patient about lifestyle changes to lower blood glucose is the most appropriate action at this stage.

2. Upon noticing a visitor who is loud and active and carrying a gun on the unit where you are in charge, what should you do immediately?

• A. Ask the visitor to leave.
• B. Talk quietly to calm the visitor.
• C. Ask the visitor for the gun.
• D. Notify security with the details of the situation.

Correct answer: D

Rationale: In a situation where a visitor arrives on the unit with a gun, it is essential to prioritize the safety of patients and staff. Immediately notifying security with all the relevant details is the correct course of action. Asking the visitor to leave or engaging them could escalate the situation and put everyone at risk. Similarly, requesting the gun from the visitor directly is not advisable as it could lead to a dangerous confrontation. By alerting security promptly, you enable trained professionals to handle the situation safely and effectively, minimizing risks and ensuring the safety of all individuals involved.

3. A nurse is completing an admission assessment for a client who reports vomiting and diarrhea for the past 3 days. Which of the following findings should the nurse expect?

• A. Blood pressure 144/82 mm Hg
• B. Urine specific gravity 1.03
• C. Neck vein distention
• D. Urine specific gravity 1.01

Correct answer: A

Rationale: In a client experiencing vomiting and diarrhea, the nurse should expect findings such as dehydration, which can lead to hypovolemia and subsequent increased heart rate and decreased blood pressure. A blood pressure of 144/82 mm Hg is indicative of possible dehydration in this client. Urine specific gravity is typically increased in dehydrated individuals, so choices B and D are incorrect. Neck vein distention is not a typical finding associated with vomiting and diarrhea; therefore, choice C is also incorrect.

4. A recent ethical issue has resulted in uneasiness and discomfort for several nurses on a unit. The unit manager has decided to discuss the issues at the next team meeting. The situation has resulted in which of the following for some of the nurses?

• A. Moral suffering
• B. Moral distress
• C. Ethical dilemma
• D. Veracity

Correct answer: A

Rationale: Moral suffering occurs when a situation results in a feeling of uneasiness or concern because of behaviors or circumstances that challenge one�s own morals and beliefs.

5. A 38-year-old patient who has type 1 diabetes plans to swim laps daily at 1:00 PM. The clinic nurse will plan to teach the patient to

• A. check glucose levels before, during, and after swimming.
• B. delay eating the noon meal until after swimming.
• C. increase the morning dose of neutral protamine Hagedorn (NPH) insulin.
• D. time the morning insulin injection so that the peak occurs while swimming.

Correct answer: A

Rationale: The correct answer is to teach the patient to check glucose levels before, during, and after swimming. This is important to monitor blood sugar levels and make adjustments as needed to prevent hypoglycemia or hyperglycemia. Delaying eating the noon meal until after swimming (Choice B) is not advisable as the patient needs proper nutrition both before and after exercise. Increasing the morning dose of NPH insulin (Choice C) should not be done without proper medical advice as it can lead to hypoglycemia. Timing the morning insulin injection to coincide with swimming (Choice D) is risky as the peak effect of insulin may lead to hypoglycemia during swimming.

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