Nursing Elites

1. A client with diabetes experiences Somogyi's effect. To prevent this complication, the nurse should instruct the client to:

• A. Take insulin at 2:00 PM each day
• B. Engage in physical activity daily
• C. Increase the dose of regular insulin
• D. Eat a protein and carbohydrate snack at bedtime

Correct answer: D

Rationale: Somogyi effect, also known as rebound hyperglycemia, occurs as a response to nighttime hypoglycemia. Eating a protein and carbohydrate snack at bedtime can help prevent this by stabilizing blood sugar levels throughout the night. Instructing the client to take insulin at 2:00 PM each day (Choice A) may not directly address the nighttime hypoglycemia concern. Engaging in physical activity daily (Choice B) is generally beneficial for diabetes management but may not specifically prevent Somogyi's effect. Increasing the dose of regular insulin (Choice C) without addressing the nighttime hypoglycemia issue can exacerbate the problem.

2. Which of the following best describes cultural competence in healthcare?

• A. Ignoring cultural differences
• B. Understanding and respecting cultural differences
• C. Enforcing cultural norms
• D. Focusing solely on medical knowledge

Correct answer: B

Rationale: Cultural competence in healthcare involves understanding and respecting cultural differences to provide effective and respectful care to patients from diverse backgrounds. Choice A is incorrect as ignoring cultural differences goes against the principles of cultural competence. Choice C is wrong because enforcing cultural norms can be culturally insensitive and may not align with the patient's beliefs. Choice D is also incorrect as cultural competence encompasses more than just medical knowledge, including communication, empathy, and awareness of cultural factors.

3. How many calories per kilogram does an average full-term infant require when the infant is around 1-2 months old?

• A. 140 calories per kilogram per day
• B. 120 calories per kilogram per day
• C. 100 calories per kilogram per day
• D. 160 calories per kilogram per day

Correct answer: B

Rationale: An average full-term infant requires about 120 calories per kilogram per day at 1-2 months old. This amount is essential for their growth and development during this critical stage. Choices A, C, and D are incorrect as they provide calorie amounts that are either too high or too low for an average full-term infant at 1-2 months old, which could potentially lead to health issues or inadequate nutrition.

4. Round off these numbers to the nearest tenth:

• A. 5.5778 = 5.6, 1.027 = 1.0, 62.999 = 63, 55.123 = 55.1, 96.676 = 96.7
• B. 5.5778 = 5.6, 1.027 = 1.0, 62.999 = 63, 55.123 = 55.1, 96.676 = 96.7
• C. 5.5778 = 5.6, 1.027 = 1.0, 62.999 = 63, 55.123 = 55.1, 96.676 = 96.7
• D. 5.5778 = 5.6, 1.027 = 1.0, 62.999 = 63, 55.123 = 55.1, 96.676 = 96.7

Correct answer: B

Rationale: The correct answer is B. When rounding off to the nearest tenth, 1.027 becomes 1.0 because the digit in the hundredth's place is less than 5. For the other numbers, they are rounded correctly to the nearest tenth: 5.5778 = 5.6, 62.999 = 63, 55.123 = 55.1, 96.676 = 96.7. Therefore, option B is the most accurate in rounding off these numbers to the nearest tenth. Choices A, C, and D are incorrect as they do not round 1.027 to 1.0 as required when rounding to the nearest tenth.

5. Which healthcare-associated infection poses the greatest risk for patients?

• A. Pneumonia
• B. Catheter-related infections
• C. Intravenous line infections
• D. C. difficile

Correct answer: B

Rationale: Catheter-related infections pose the greatest risk for patients in healthcare settings. Catheters are invasive devices that can introduce pathogens directly into the bloodstream, leading to severe infections. Pneumonia, intravenous line infections, and C. difficile infections are serious concerns as well, but catheter-related infections are particularly risky due to the direct access they provide for pathogens to enter the body.

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