Nursing Elites

1. A client with diabetes mellitus is learning to self-administer insulin. Which action by the client indicates the need for further teaching?

• A. The client rotates injection sites on the abdomen.
• B. The client draws up the insulin dose after warming the vial to room temperature.
• C. The client pinches the skin before injecting the insulin.
• D. The client injects the insulin at a 90-degree angle.

Correct answer: B

Rationale: Drawing up insulin after warming the vial to room temperature indicates a need for further teaching, as insulin should be at room temperature for administration. Choice A is correct as rotating injection sites helps prevent lipodystrophy. Choice C is correct as pinching the skin helps ensure proper subcutaneous injection. Choice D is correct as injecting insulin at a 90-degree angle is the recommended technique for subcutaneous injections.

2. The healthcare provider is caring for a client with a history of deep vein thrombosis (DVT). Which symptom would be most concerning?

• A. Pain in the affected leg
• B. Redness and warmth in the affected leg
• C. Shortness of breath
• D. Swelling in the affected leg

Correct answer: C

Rationale: Shortness of breath is the most concerning symptom in a client with a history of deep vein thrombosis (DVT) because it could indicate a pulmonary embolism. A pulmonary embolism is a serious complication of DVT where a blood clot travels to the lungs and can be life-threatening. Immediate medical attention is required to prevent further complications. Pain, redness, warmth, and swelling in the affected leg are common symptoms of DVT itself but do not pose the same level of immediate danger as the potential for a pulmonary embolism.

3. A client is talking with an older adult who is contemplating retirement. The client states, 'I keep thinking about how much I enjoy my job. I’m not sure I want to retire.' Which of the following responses should the nurse make?

• A. Let’s talk about how the change in your job status will affect you.
• B. You should consider how retirement will affect your financial situation.
• C. Retirement is a big change, take your time to decide.
• D. Have you thought about what you will do after you retire?

Correct answer: A

Rationale: The correct response is to discuss how the change in job status will affect the client. This helps the client consider the emotional and psychological impact of retirement. Choice B focuses solely on the financial aspect of retirement, which may not address the client's current concerns about enjoying their job. Choice C acknowledges the decision-making process but does not actively engage the client in exploring their feelings. Choice D shifts the focus to post-retirement plans without addressing the client's current hesitation about retiring.

4. A nurse at a provider’s office is discussing routine screenings with a 45-year-old female client who has no specific family history of cancer or diabetes mellitus. Which of the following client statements indicates that the client understands how to proceed?

• A. “So I don’t need the colon cancer screening for another 2 or 3 years.”
• B. “For now, I should continue to have a mammogram each year.”
• C. “Because the doctor just performed a Pap smear, I’ll return next year for another one.”
• D. “I had my glucose test last year, so I won’t need it again for 4 years.”

Correct answer: B

Rationale: The correct answer is B. Mammograms are recommended annually for women starting at age 40 or 45. This statement aligns with current guidelines for breast cancer screening in women without specific risk factors. Choice A is incorrect because colon cancer screenings are typically recommended at different intervals. Choice C is incorrect as Pap smears are usually done every 3-5 years based on age and risk factors. Choice D is incorrect because glucose testing is usually recommended more frequently, especially for individuals at risk for diabetes mellitus.

5. The healthcare provider is providing teaching to an immobilized patient with impaired skin integrity about diet. Which diet will the healthcare provider recommend?

• A. High protein, high calorie
• B. High carbohydrate, low fat
• C. High vitamin A, high vitamin E
• D. Fluid restricted, bland

Correct answer: A

Rationale: The correct answer is A: High protein, high calorie. An immobilized patient with impaired skin integrity requires a diet high in protein and calories to repair injured tissue and rebuild depleted protein stores. This helps in promoting wound healing and preventing further breakdown of the skin. Choices B, C, and D are incorrect because while vitamins and minerals are essential for overall health, in this case, the priority is on providing sufficient protein and calories to support healing and recovery in an immobilized patient with impaired skin integrity.

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