Nursing Elites

1. A client with a history of diabetes mellitus is admitted with diabetic ketoacidosis (DKA). Which finding requires immediate intervention?

• A. Blood glucose of 200 mg/dL.
• B. Serum bicarbonate of 20 mEq/L.
• C. Blood pressure of 140/90 mm Hg.
• D. Urine output of 50 mL in 4 hours.

Correct answer: D

Rationale: In a client with diabetic ketoacidosis (DKA), urine output of 50 mL in 4 hours indicates oliguria, which is a concerning sign of decreased renal perfusion and potential renal failure. This finding requires immediate intervention to prevent further deterioration of kidney function.\n\nChoice A (Blood glucose of 200 mg/dL) is elevated but not the most urgent concern in this scenario. Choice B (Serum bicarbonate of 20 mEq/L) reflects metabolic acidosis, which is expected in DKA but does not require immediate intervention. Choice C (Blood pressure of 140/90 mm Hg) is slightly elevated but not acutely concerning in the context of DKA.

2. The healthcare professional is developing a health education program for adolescents on the dangers of smoking. Which strategy is most likely to be effective?

• A. showing graphic images of the effects of smoking
• B. inviting former smokers to share their experiences
• C. providing statistical data on smoking-related illnesses
• D. distributing pamphlets on smoking cessation resources

Correct answer: B

Rationale: Inviting former smokers to share their experiences is the most effective strategy because personal stories can have a powerful impact on adolescents and motivate them to avoid smoking. This approach makes the consequences of smoking more relatable and real, potentially influencing behavior change. Showing graphic images may be too harsh and could lead to desensitization or avoidance of the issue. Providing statistical data may not resonate as strongly with adolescents as personal stories. Distributing pamphlets, while informative, may not have the same emotional impact as hearing real-life experiences.

3. The healthcare professional is developing a program to educate parents on childhood nutrition. Which topic should be prioritized?

• A. the benefits of organic foods
• B. how to read nutrition labels
• C. the importance of a balanced diet
• D. ways to incorporate more vegetables into meals

Correct answer: C

Rationale: Prioritizing the topic of the importance of a balanced diet is crucial as it provides a fundamental understanding for parents to establish healthy eating habits for their children. Understanding the importance of a balanced diet helps parents make informed decisions about food choices, portion sizes, and meal planning. Option A, focusing on the benefits of organic foods, while valuable, may not be feasible or affordable for all families. Option B, teaching parents how to read nutrition labels, is important but secondary to understanding the overall concept of a balanced diet. Option D, discussing ways to incorporate more vegetables into meals, is beneficial but should come after establishing the foundation of a balanced diet.

4. The nurse is assessing a client who complains of weight loss, racing heart rate, and difficulty sleeping. The nurse determines the client has moist skin with fine hair, prominent eyes, lid retraction, and a staring expression. These findings are consistent with which disorder?

• A. Graves' disease.
• B. Cushing's syndrome.
• C. Addison's disease.
• D. Hypothyroidism.

Correct answer: A

Rationale: The correct answer is A, Graves' disease. The symptoms described in the client are classic manifestations of hyperthyroidism, which is commonly caused by Graves' disease, an autoimmune condition affecting the thyroid. Weight loss, racing heart rate, difficulty sleeping, moist skin with fine hair, prominent eyes, lid retraction, and a staring expression are all indicative of hyperthyroidism. Choice B, Cushing's syndrome, is characterized by weight gain, hypertension, and a rounded face due to excess cortisol. Choice C, Addison's disease, presents with symptoms such as weight loss, fatigue, and hyperpigmentation due to adrenal insufficiency. Choice D, hypothyroidism, typically features symptoms opposite to those described in the client, such as weight gain, bradycardia, and dry skin.

5. The nurse is assessing a client with a suspected deep vein thrombosis (DVT). Which finding supports this diagnosis?

• A. Positive Homan's sign.
• B. Unilateral leg swelling.
• C. Bilateral calf pain.
• D. Redness and warmth in the affected leg.

Correct answer: D

Rationale: The correct answer is D: Redness and warmth in the affected leg. These are classic signs of deep vein thrombosis (DVT) and support the diagnosis. Choice A, Positive Homan's sign, is an outdated and unreliable test for DVT, so it is not the best choice. Choice B, Unilateral leg swelling, can be seen in DVT but is less specific compared to redness and warmth. Choice C, Bilateral calf pain, is not a typical finding in DVT, as the pain in DVT is usually unilateral.

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