Nursing Elites

1. A client with diabetes mellitus is being educated on the signs and symptoms of hypoglycemia. Which of the following symptoms should the client be instructed to report immediately?

• A. Shakiness
• B. Sweating
• C. Confusion
• D. Increased thirst

Correct answer: C

Rationale: Confusion is a critical symptom of hypoglycemia that indicates the brain is not receiving enough glucose, potentially leading to serious complications like unconsciousness or seizures. Immediate reporting of confusion is essential for prompt intervention to prevent worsening of hypoglycemia. Shakiness and sweating are early warning signs of hypoglycemia but may not always require immediate intervention. Increased thirst is a symptom commonly associated with hyperglycemia rather than hypoglycemia.

2. Which of the following describes an effective method of communication?

• A. A unit manager meets with a new nurse to discuss what is going well and areas for improvement.
• B. A unit manager meets with a new nurse to explain departmental policies.
• C. A unit manager meets with staff after several safety events to introduce new policies aimed at preventing further safety events.
• D. A unit manager describes safety events that have occurred on the unit to another nurse manager and discusses ideas for policy improvement with the other manager.

Correct answer: A

Rationale: Choice A is the correct answer because it describes an effective method of communication where a unit manager meets with a new nurse to discuss what is going well and areas for improvement. This approach fosters open dialogue, provides constructive feedback, and promotes professional growth. Choice B is incorrect as it only involves the explanation of departmental policies without engaging in a two-way communication process. Choice C is incorrect as it focuses on policy introduction after safety events rather than individual feedback. Choice D is incorrect as it involves discussing safety events with another manager and policy improvement, but it does not directly address individual performance feedback, which is essential for effective communication and professional development.

3. A client with diabetes mellitus is experiencing polyuria, polydipsia, and polyphagia. Which of the following actions should the nurse take?

• A. Administer insulin
• B. Encourage increased fluid intake
• C. Monitor for signs of dehydration
• D. Check blood glucose levels

Correct answer: D

Rationale: Polyuria, polydipsia, and polyphagia are classic signs of hyperglycemia, indicating high blood glucose levels. The priority action for the nurse is to check the client's blood glucose levels to assess the severity of hyperglycemia and determine the need for appropriate interventions. Administering insulin (Choice A) may be necessary based on the blood glucose levels but should only be done after confirming the current status. Encouraging increased fluid intake (Choice B) may exacerbate the symptoms by further diluting the blood glucose concentration. While monitoring for signs of dehydration (Choice C) is important in the long term, the immediate action should focus on determining the blood glucose levels first.

4. In a client with hypoparathyroidism, the nurse should expect which laboratory result?

• A. Increased calcium levels
• B. Decreased phosphorus levels
• C. Increased phosphorus levels
• D. Increased potassium levels

Correct answer: C

Rationale: In hypoparathyroidism, there is a deficiency of parathyroid hormone, leading to decreased calcium levels and increased phosphorus levels. Therefore, the correct answer is 'Increased phosphorus levels' (Choice C). Choice A, 'Increased calcium levels,' is incorrect because hypoparathyroidism is associated with low calcium levels. Choice B, 'Decreased phosphorus levels,' is incorrect as phosphorus levels are typically elevated in hypoparathyroidism. Choice D, 'Increased potassium levels,' is not directly related to hypoparathyroidism and is not an expected laboratory result in this condition.

5. Which of the following statements should be included in the teaching to a client about a do-not-resuscitate order (DNR)?

• A. When a heart ceases to beat, the client is pronounced clinically dead.
• B. Physicians are required to write DNR orders.
• C. A DNR order can be written after discussion with the client and family.
• D. A court decision is needed for a DNR.

Correct answer: C

Rationale: The correct statement to include in teaching a client about a do-not-resuscitate (DNR) order is that it can be written after discussion with the client and family. This involves ensuring that the client and their family understand the implications and make an informed decision. Choice A is incorrect as pronouncing clinical death is not directly related to discussing a DNR order. Choice B is incorrect as while physicians typically write DNR orders, it is not a strict requirement. Choice D is incorrect as a court decision is not typically required for a DNR order; it is a decision made by the client with input from healthcare providers and family members.

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