Nursing Elites

1. A client with diabetes is being discharged. What is an essential teaching point?

• A. Monitor blood sugar levels once a week
• B. Instruct the client to administer insulin before meals
• C. Teach the client to exercise regularly to maintain glucose control
• D. Administer oral hypoglycemics as needed

Correct answer: B

Rationale: Instructing the client to administer insulin before meals is a crucial teaching point for a client with diabetes. This action ensures proper glucose management by helping to control blood sugar levels. Monitoring blood sugar levels once a week (Choice A) may not be frequent enough to manage diabetes effectively. While regular exercise (Choice C) is beneficial for glucose control, the immediate administration of insulin is more critical at the time of discharge. Administering oral hypoglycemics as needed (Choice D) is inappropriate as it does not address the need for insulin administration for a client being discharged.

2. A nurse is observing an assistive personnel (AP) caring for a client. For which of the following actions by the AP should the nurse intervene?

• A. Providing care in the hallway
• B. Reporting client information in the hallway
• C. Helping another client use the restroom
• D. Feeding the client too quickly

Correct answer: B

Rationale: The correct answer is B because reporting client information in the hallway violates privacy regulations, compromising patient confidentiality. Providing care in the hallway (choice A) may not be ideal but is not a direct violation. Helping another client use the restroom (choice C) shows the AP's willingness to assist but is not a concern unless it compromises the current client's safety. Feeding the client too quickly (choice D) is a potential concern for aspiration but may not require immediate intervention as addressing hydration and swallowing strategies can help prevent complications.

3. A client with hypertension is asking for lifestyle changes. What should the nurse recommend?

• A. Increase sodium intake to manage blood pressure
• B. Reduce caffeine and alcohol consumption
• C. Encourage the client to increase protein intake
• D. Increase intake of fruits and vegetables

Correct answer: B

Rationale: The correct answer is B: Reduce caffeine and alcohol consumption. This recommendation is crucial for managing hypertension as excessive caffeine and alcohol intake can elevate blood pressure. By reducing these stimulants, the client can help regulate their blood pressure levels. Choices A, C, and D are incorrect. Increasing sodium intake (Choice A) is contraindicated in hypertension as it can lead to fluid retention and worsen blood pressure. Encouraging increased protein intake (Choice C) and increasing intake of fruits and vegetables (Choice D) are generally healthy dietary suggestions but not specifically targeted at managing hypertension.

4. Which dietary restriction should be taught to a client with chronic kidney disease?

• A. Increase potassium-rich foods
• B. Limit phosphorus and potassium intake
• C. Encourage increased protein intake
• D. Increase fluid intake

Correct answer: B

Rationale: The correct answer is B: Limit phosphorus and potassium intake. In chronic kidney disease, the kidneys are unable to effectively filter these minerals from the blood, leading to their accumulation and potential complications. Restricting phosphorus and potassium intake is crucial in managing the progression of the disease. Choice A is incorrect as increasing potassium-rich foods can worsen the condition. Choice C is also incorrect as excessive protein intake can put more strain on the kidneys. Choice D is not the priority; rather, fluid intake should be monitored based on individual needs and stage of kidney disease.

5. A nurse is delegating the ambulation of a client who had knee arthroplasty 5 days ago to an AP. Which of the following information should the nurse share with the AP?

• A. The roommate is up independently
• B. The client ambulates with his slippers on over his antiembolic stockings
• C. The client uses a front-wheeled walker when ambulating
• D. The client had pain meds 30 minutes ago

Correct answer: C

Rationale: The correct answer is C. After knee arthroplasty, it is essential for the client to use a front-wheeled walker when ambulating to ensure stability and prevent falls. Sharing this information with the assistive personnel (AP) is crucial for the client's safety and proper rehabilitation. Choices A, B, and D are incorrect because the roommate's independence, the client's footwear over stockings, and the timing of pain medication administration are not directly related to the safe ambulation of a client post-knee arthroplasty.

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