Nursing Elites

1. A client with diabetes mellitus is receiving insulin glargine (Lantus). The nurse should monitor the client for which of the following side effects?

• A. Hypoglycemia
• B. Hyperkalemia
• C. Hypertension
• D. Hypercalcemia

Correct answer: A

Rationale: Insulin glargine is a long-acting insulin used to control blood sugar levels in diabetes. The nurse should monitor the client for hypoglycemia, which is a potential side effect of insulin therapy. Hypoglycemia occurs when blood sugar levels drop too low, leading to symptoms such as shakiness, dizziness, sweating, confusion, and in severe cases, loss of consciousness. Hyperkalemia (choice B) is an elevated potassium level, not typically associated with insulin glargine. Hypertension (choice C) is high blood pressure, which is not a common side effect of insulin glargine. Hypercalcemia (choice D) is an elevated calcium level and is not related to the use of insulin glargine.

2. The family presents several problems. Which of the following criteria is considered in determining the priority health problem?

• A. expected consequence of the problem
• B. cooperation and support of the family
• C. involvement of the family members in the problem
• D. modifiability of the problem

Correct answer: D

Rationale: When determining the priority health problem within a family, one key criterion to consider is the modifiability of the problem. This means assessing whether the health issue can be changed or improved through interventions. Choices A, B, and C are not directly related to the priority of the health problem within the family. The expected consequence of the problem, cooperation and support of the family, and involvement of family members are important factors but do not specifically address the priority of the health issue based on modifiability.

3. An example of secondary prevention strategy would be:

• A. Screening for breast cancer in women who have no symptoms
• B. Using pain control medications for terminal cancer patients
• C. Educating teenagers about using condoms to prevent STDs
• D. None of the above

Correct answer: A

Rationale: The correct answer is A. Screening for breast cancer is a secondary prevention strategy aimed at early detection, which falls under secondary prevention as it focuses on early identification and intervention before the disease progresses. Choice B is incorrect as it refers to palliative care for symptom management in terminal cancer patients, which is not a secondary prevention strategy. Choice C is incorrect as educating teenagers about condom use is a primary prevention strategy to prevent the initial occurrence of STDs rather than intervening after exposure, making it a primary, not a secondary prevention strategy. Choice D is incorrect as there is a valid example of a secondary prevention strategy provided in choice A.

4. A client with a peptic ulcer is scheduled for a vagotomy and pyloroplasty. The nurse explains that the purpose of this surgery is to:

• A. Increase acid secretion
• B. Reduce acid secretion
• C. Promote gastric emptying
• D. Remove the ulcerated area

Correct answer: B

Rationale: The correct answer is B: "Reduce acid secretion." Vagotomy is performed to reduce acid secretion by cutting the vagus nerve, which stimulates acid production. Choices A, C, and D are incorrect. A vagotomy does not increase acid secretion, promote gastric emptying, or remove the ulcerated area. It specifically aims to decrease acid production to help in the healing of peptic ulcers.

5. The client with Raynaud's phenomenon would benefit most by which teaching intervention?

• A. Stop smoking
• B. Keep feet dry
• C. Reduce stress
• D. Avoid caffeine

Correct answer: A

Rationale: The correct answer is A: Stop smoking. Smoking causes vasoconstriction, worsening the symptoms of Raynaud's phenomenon. Quitting smoking is crucial in managing this condition effectively. Choices B, C, and D are not as directly related to the pathophysiology of Raynaud's phenomenon. While keeping feet dry and reducing stress can be beneficial for overall health, they are not as directly linked to managing Raynaud's phenomenon as smoking cessation.

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