Nursing Elites

1. A 9-year-old female client was recently diagnosed with diabetes mellitus. Which symptom will her parents most likely report?

• A. Refuses to eat her favorite meals at home.
• B. Drinks more soft drinks than previously.
• C. Voids only one or two times per day.
• D. Gained 10 pounds within one month.

Correct answer: B

Rationale: The correct answer is B. Increased thirst and fluid intake, such as drinking more soft drinks than previously, is a common symptom of diabetes mellitus in children. This increased thirst is due to the body trying to eliminate excess sugar through urination, leading to dehydration and the need for more fluids. The other choices are less likely to be directly related to the diagnosis of diabetes mellitus in this scenario.

2. The client with a history of heart failure is taking furosemide (Lasix). Which laboratory result should the nurse monitor closely?

• A. Serum sodium.
• B. Serum potassium.
• C. Serum calcium.
• D. Serum magnesium.

Correct answer: B

Rationale: Furosemide (Lasix) is a loop diuretic that can lead to potassium loss, causing hypokalemia. Monitoring serum potassium levels is crucial to prevent complications such as cardiac dysrhythmias associated with low potassium levels.

3. A client with a newly created ileostomy has not had ostomy output for the past 12 hours and reports worsening nausea. What is the nurse's priority action?

• A. Facilitate a referral to the wound-ostomy-continence (WOC) nurse
• B. Report signs and symptoms of obstruction to the health care provider
• C. Encourage the client to mobilize to enhance mobility
• D. Contact the health care provider to obtain a swab of the stoma for culture

Correct answer: B

Rationale: The nurse's priority action in this situation is to report signs and symptoms of possible obstruction to the healthcare provider. Lack of ostomy output and worsening nausea can indicate a potential obstruction, which requires immediate attention and intervention to prevent complications.

4. What is the primary advantage of prescribing rivaroxaban over warfarin for a patient with a history of deep vein thrombosis (DVT)?

• A. No need for regular INR monitoring
• B. Lower risk of bleeding
• C. Fewer dietary restrictions
• D. Longer half-life

Correct answer: A

Rationale: The primary advantage of prescribing rivaroxaban over warfarin for a patient with a history of deep vein thrombosis (DVT) is that rivaroxaban does not require regular INR monitoring. This eliminates the need for frequent blood tests to adjust the dosage, making it more convenient for patients to manage their anticoagulant therapy.

5. A client with a history of diabetes mellitus presents with confusion, sweating, and palpitations. What should the nurse do first?

• A. Check the client's blood glucose level.
• B. Administer 10 units of insulin.
• C. Give the client a high-protein snack.
• D. Measure the client's blood pressure.

Correct answer: A

Rationale: The correct first action for a client presenting with confusion, sweating, and palpitations, suggestive of hypoglycemia, is to check the client's blood glucose level. This step helps to confirm if the symptoms are due to low blood sugar levels and guides appropriate interventions. Administering insulin without knowing the current blood glucose level can be dangerous and is not recommended as the initial step. Offering a high-protein snack may be necessary after confirming hypoglycemia, but checking the blood glucose level takes precedence. Measuring blood pressure is not the priority in this situation; addressing hypoglycemia is the immediate concern.

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