Nursing Elites

1. A client is admitted with diabetic ketoacidosis. What is the most critical treatment to initiate?

• A. Administer sodium bicarbonate IV
• B. Start an insulin drip
• C. Monitor glucose and ketone levels
• D. Provide oral hydration

Correct answer: B

Rationale: In the case of diabetic ketoacidosis, the most critical treatment to initiate is starting an insulin drip. Insulin therapy is crucial for reducing blood glucose levels by promoting glucose uptake in cells and inhibiting the production of ketones. Administering sodium bicarbonate IV is generally not recommended as it may lower the pH further and potentially worsen the condition. While monitoring glucose and ketone levels is important for assessing the response to treatment, initiating insulin therapy takes precedence. Providing oral hydration alone is insufficient to manage the metabolic derangements seen in diabetic ketoacidosis.

2. The nurse is preparing to administer an intramuscular injection to a 6-month-old infant. Which site is most appropriate for this injection?

• A. Deltoid muscle
• B. Ventrogluteal muscle
• C. Dorsogluteal muscle
• D. Vastus lateralis muscle

Correct answer: D

Rationale: The vastus lateralis muscle is the preferred site for intramuscular injections in infants due to its size and safety. The deltoid muscle is typically used for adults and older children. The ventrogluteal muscle is more commonly used in toddlers and older children. The dorsogluteal muscle is not recommended for intramuscular injections in any age group due to its proximity to major nerves and blood vessels, which poses a risk of injury or sciatic nerve damage.

3. When teaching a group of school-aged children how to reduce the risk for Lyme disease, which instruction should the camp nurse include?

• A. Wash hands frequently.
• B. Avoid drinking lake water.
• C. Do not share personal products.
• D. Wear long sleeves and pants.

Correct answer: D

Rationale: The correct answer is 'Wear long sleeves and pants.' This instruction is crucial in reducing the risk of Lyme disease because it helps minimize exposure to ticks that carry the disease. Ticks are commonly found in grassy and wooded areas, so covering up with long sleeves and pants can act as a physical barrier and prevent ticks from attaching to the skin. Choices A, B, and C are not directly related to preventing Lyme disease. Washing hands frequently is important for general hygiene but not specifically for preventing tick bites. Avoiding drinking lake water is more about preventing waterborne illnesses rather than Lyme disease. Not sharing personal products is important for preventing the spread of infections but is not directly related to Lyme disease prevention.

4. A client with type 1 diabetes mellitus is learning to administer insulin. What is the best site for the nurse to recommend for insulin injection?

• A. Abdomen
• B. Thigh
• C. Upper arm
• D. Buttock

Correct answer: A

Rationale: The correct answer is the abdomen. The abdomen is the recommended site for insulin injection due to its faster absorption rate compared to other sites. Insulin injected into the abdomen is absorbed more quickly, leading to better glycemic control. The thigh and upper arm are also common sites for insulin injection, but they have slower absorption rates than the abdomen. The buttock is not a preferred site for insulin injection due to inconsistent absorption and potential risk of injecting into muscle instead of fatty tissue.

5. A client with a diagnosis of deep vein thrombosis (DVT) is receiving anticoagulant therapy. Which instruction should the nurse provide to the client?

• A. Avoid walking as much as possible
• B. Report any signs of bleeding to the healthcare provider
• C. Take aspirin for additional pain relief
• D. Wear compression stockings at night

Correct answer: B

Rationale: Reporting signs of bleeding is essential while on anticoagulant therapy to prevent complications.

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