Nursing Elites

1. A client with diabetes mellitus is being educated on the importance of foot care. Which of the following instructions should the nurse include?

• A. Soak your feet daily to maintain cleanliness.
• B. Wear tight-fitting shoes to protect your feet.
• C. Apply lotion between your toes to prevent dryness.
• D. Inspect your feet daily for any cuts or sores.

Correct answer: D

Rationale: The correct answer is to instruct the client to inspect their feet daily for any cuts or sores. This is crucial for individuals with diabetes as they are at a higher risk of developing foot problems. Soaking feet daily can lead to skin breakdown and infections, making choice A incorrect. Tight-fitting shoes can cause pressure points and increase the risk of foot injuries, so choice B is incorrect. Applying lotion between the toes can create a moist environment, increasing the risk of fungal infections, making choice C incorrect.

2. A nurse manager is focusing on improving communication on the unit. Which of the following best describes the importance of this focus?

• A. The nurse manager's focus on communication is essential to ensure that all staff members are informed, understand their roles, and can work together effectively to provide quality care.
• B. The nurse manager's focus on communication is important to ensure that information is shared effectively and that there is a clear understanding of roles and responsibilities on the unit.
• C. The nurse manager's focus on communication is crucial to ensuring that all staff members are working together effectively and that there is a shared understanding of the unit's goals and priorities.
• D. The nurse manager's focus on communication is vital to creating an open and transparent environment where staff members feel comfortable sharing information and concerns.

Correct answer: A

Rationale: The correct answer is A. Effective communication is essential for ensuring that all staff members are informed, understand their roles, and can collaborate effectively to provide quality care. Choice B focuses more on information sharing and understanding roles but lacks emphasis on effective teamwork and quality care provision. Choice C mentions staff working together effectively and understanding unit goals, but it does not explicitly highlight the importance of staff being informed and understanding their roles. Choice D emphasizes creating an open environment for sharing information and concerns, which is important but does not encompass the broader aspects of effective communication as described in choice A.

3. A client with Addison's disease is receiving corticosteroid therapy. The nurse should monitor for which of the following potential side effects?

• A. Hypoglycemia
• B. Hyperkalemia
• C. Hyperglycemia
• D. Hyponatremia

Correct answer: C

Rationale: The correct answer is C, Hyperglycemia. Corticosteroid therapy can lead to hyperglycemia by increasing blood glucose levels. Corticosteroids can induce insulin resistance, decrease glucose uptake by tissues, and promote gluconeogenesis. While corticosteroid therapy can cause hypoglycemia in some cases, it is more commonly associated with hyperglycemia. Hyperkalemia (choice B) is more commonly associated with conditions like renal failure or certain medications. Hyponatremia (choice D) is typically not a common side effect of corticosteroid therapy unless there are other contributing factors present.

4. As a nurse manager rounds on the unit, he speaks with staff, patients, and family members. Later in the day, he is in a meeting with administration. During the conversations, he considers how these interactions impact the care provided to patients on the unit. Which of the following interpersonal activities best describes this manager’s actions?

• A. Networking
• B. Employee development
• C. Coaching
• D. Monitoring

Correct answer: A

Rationale: The correct answer is 'Networking.' Networking involves building relationships and connecting with staff, patients, and family members to establish a supportive network. In this scenario, the nurse manager is engaging in networking by interacting with various individuals to understand how these interactions influence patient care. 'Employee development' involves activities aimed at enhancing employees' skills and knowledge. 'Coaching' focuses on guiding individuals to improve performance, while 'Monitoring' involves overseeing and supervising activities to ensure compliance and quality.

5. The nurse is caring for a client with congestive heart failure. On assessment, the nurse notes that the client is dyspneic and that crackles are audible on auscultation. The nurse suspects excess fluid volume. What additional signs would the nurse expect to note in this client if excess fluid volume is present?

• A. Weight loss
• B. Flat neck and hand veins
• C. An increase in blood pressure
• D. A decreased central venous pressure (CVP)

Correct answer: C

Rationale: An increase in blood pressure is a common sign of fluid volume excess in clients with congestive heart failure due to the increased amount of fluid in the vascular system. Weight loss (Choice A) is not typically associated with fluid volume excess. Flat neck and hand veins (Choice B) are signs of fluid volume deficit, not excess. A decreased central venous pressure (CVP) (Choice D) is not expected in a client with fluid volume excess.

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