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. Select the criteria that is accurately paired with its indication of birth weight or gestational age.

• A. Low birth weight: The neonate's weight is less than 1,500 g at the time of delivery.
• B. Appropriate for gestational age: The neonate's weight ranges from the 10th to the 90th percentile.
• C. Large for gestational age: The neonate's weight is above the 99th percentile.
• D. Small for gestational age: The neonate's weight is below the 20th percentile.

Correct answer: B

Rationale: Appropriate for gestational age (AGA) indicates a neonate's weight ranging from the 10th to the 90th percentile. This range signifies that the baby's weight is within the normal range for their gestational age. Choices A, C, and D provide inaccurate information about the criteria and do not correctly correspond to the indicated birth weight or gestational age. Low birth weight typically refers to a weight below 2,500 g, large for gestational age above the 90th percentile, and small for gestational age below the 10th percentile.

3. Who is credited with the stages of cognitive development?

• A. Erikson
• B. Piaget
• C. Freud
• D. Lister

Correct answer: B

Rationale: Piaget is indeed credited with the stages of cognitive development. Jean Piaget, a renowned psychologist, proposed a theory of cognitive development that outlines distinct stages through which children develop intellectually. Erikson, Freud, and Lister are not associated with the stages of cognitive development. Erikson is known for his psychosocial stages, Freud for psychosexual stages, and Lister for contributions to the field of medicine.

4. A nurse is caring for a client who reports acute pain but refuses IM medication. The nurse distracts the client and quickly administers the injection. This illustrates which of the following?

• A. Assault
• B. False imprisonment
• C. Battery
• D. Libel

Correct answer: C

Rationale: The correct answer is C, 'Battery.' Administering the injection without the client's consent constitutes battery. Assault involves the threat of harm, not the actual act. False imprisonment is restraining a client against their will, which does not apply here. Libel refers to a false written statement, which is not relevant in this scenario.

5. Which of the following is considered normal for the neonate?

• A. Chest Circumference: 10 to 13 inches
• B. Length: 16 to 22 inches
• C. Weight: 1,500 to 4,000 g
• D. Head Circumference: 12.6 to 14.5 inches

Correct answer: D

Rationale: A normal head circumference for a neonate typically falls within the range of 12.6 to 14.5 inches. Choice A is incorrect because the chest circumference for a neonate is usually smaller. Choice B is incorrect as the length of a neonate is typically shorter. Choice C is incorrect as the weight of a neonate is usually measured in grams and falls within a different range.

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