Nursing Elites

1. A client with a history of chronic alcohol use is admitted with confusion and an unsteady gait. Which deficiency should the nurse suspect?

• A. Thiamine (Vitamin B1)
• B. Cyanocobalamin (Vitamin B12)
• C. Folic acid
• D. Vitamin D

Correct answer: A

Rationale: The correct answer is Thiamine (Vitamin B1). Chronic alcohol use can lead to thiamine deficiency, which can result in neurological symptoms such as confusion and an unsteady gait. Thiamine is essential for proper brain function and nerve conduction, and its deficiency is common in individuals with alcohol use disorder. Cyanocobalamin (Vitamin B12) deficiency can also present with neurological symptoms, but in this case, the patient's history of chronic alcohol use points more towards thiamine deficiency. Folic acid deficiency typically presents with symptoms like fatigue and megaloblastic anemia. Vitamin D deficiency is associated with bone health issues rather than neurological symptoms.

2. A patient with type 1 diabetes is prescribed insulin glargine. What is the primary characteristic of this insulin?

• A. Rapid-acting
• B. Intermediate-acting
• C. Long-acting
• D. Short-acting

Correct answer: C

Rationale: Insulin glargine is classified as a long-acting insulin. It is designed to provide a consistent level of insulin over approximately 24 hours, helping to keep blood glucose levels stable throughout the day. This long duration of action makes it suitable for basal insulin replacement in patients with type 1 diabetes, providing a background level of insulin to mimic the body's natural release of insulin between meals and overnight.

3. A healthcare provider is providing dietary teaching to a client with cholecystitis. Which type of diet should the healthcare provider recommend?

• A. High-fiber, low-fat diet
• B. Low-fiber, high-protein diet
• C. Low-fat, low-cholesterol diet
• D. High-protein, high-fat diet

Correct answer: C

Rationale: In cholecystitis, a low-fat, low-cholesterol diet is recommended to manage symptoms and reduce inflammation by reducing the workload on the gallbladder. This diet helps prevent gallbladder attacks and complications.

4. When should surgical correction of hypospadias typically occur for a newborn infant as advised by the nurse?

• A. Repair should be done within one month to prevent bladder infections.
• B. Repairs should typically be done before the child is potty-trained.
• C. Delaying the repair until school age reduces castration fears.
• D. To form a proper urethra repair, it should be done after sexual maturity.

Correct answer: B

Rationale: Surgical repair of hypospadias is recommended to be performed before the child is potty-trained to prevent complications. Early correction helps in achieving better outcomes and reduces the risk of issues related to urination and development of the genitalia.

5. A client with a new diagnosis of diabetes mellitus is learning to self-administer insulin. Which instruction should the nurse include?

• A. Store the insulin in the freezer.
• B. Administer the insulin at the same site each time.
• C. Rotate injection sites within the same region.
• D. Shake the vial vigorously before drawing up the insulin.

Correct answer: C

Rationale: The correct instruction for a client learning to self-administer insulin is to rotate injection sites within the same region. This practice helps prevent lipodystrophy, which is a condition characterized by fat tissue changes due to repeated injections in the same spot, and also ensures consistent absorption of insulin throughout the body. Storing insulin in the freezer is incorrect as it can lead to denaturation of the insulin. Administering the insulin at the same site each time can cause lipodystrophy and inconsistent absorption. Shaking the vial vigorously before drawing up the insulin is also incorrect as it can lead to insulin degradation.

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