Nursing Elites

1. A client with diabetes mellitus is scheduled for surgery. What is the most important preoperative instruction the nurse should provide?

• A. Take your insulin as usual
• B. Do not eat or drink after midnight
• C. Monitor your blood glucose closely
• D. Bring your glucose meter to the hospital

Correct answer: B

Rationale: The most important preoperative instruction for a client with diabetes mellitus scheduled for surgery is to instruct them not to eat or drink after midnight. This instruction is crucial to maintain NPO (nothing by mouth) status before surgery, reducing the risk of aspiration during anesthesia. While taking insulin as usual (Choice A) is important, doses can be adjusted by the healthcare team. Monitoring blood glucose closely (Choice C) is essential but not as critical preoperatively. Bringing a glucose meter to the hospital (Choice D) can be helpful but is not as vital as maintaining NPO status.

2. The client with a new diagnosis of type 2 diabetes is being taught about diet management by the nurse. Which statement by the client indicates effective learning?

• A. I should not avoid all carbohydrates
• B. I can eat whatever I want as long as I take my medication
• C. I need to eat regular meals and snacks to maintain my blood sugar levels
• D. I will decrease my intake of sugary foods to prevent low blood sugar

Correct answer: C

Rationale: Choice C is the correct answer because eating regular meals and snacks is crucial for maintaining stable blood sugar levels in individuals with diabetes. This approach helps prevent spikes and drops in blood sugar, promoting better management of the condition. Choices A, B, and D are incorrect. Avoiding all carbohydrates is not recommended as they are a major energy source and can be part of a balanced diet; eating whatever one wants while relying solely on medication can lead to uncontrolled blood sugar levels and complications; decreasing sugary foods intake can actually contribute to high blood sugar levels rather than preventing low blood sugar.

3. A client is scheduled for a sigmoidoscopy and expresses anxiety about the procedure. What should the nurse do first?

• A. Offer information about the procedure steps
• B. Administer an anxiolytic before the procedure
• C. Encourage the client to discuss their fears
• D. Reassure the client that the procedure is common and safe

Correct answer: C

Rationale: The correct first action for the nurse when a client expresses anxiety about a procedure is to encourage the client to discuss their fears. By allowing the client to express their concerns, the nurse can provide personalized support, address specific worries, and offer tailored information. This approach helps to establish trust, reduce anxiety, and promote a therapeutic nurse-client relationship. Offering information about the procedure steps (Choice A) may be helpful but should come after addressing the client's fears. Administering an anxiolytic (Choice B) should not be the first action as it focuses on symptom management rather than addressing the underlying cause of anxiety. Reassuring the client that the procedure is common and safe (Choice D) is important but should follow active listening and addressing the client's fears.

4. A client with cirrhosis is experiencing pruritus. Which intervention should the nurse include in the care plan?

• A. Administer antihistamines as prescribed
• B. Apply alcohol-based lotions to the skin
• C. Encourage frequent baths with hot water
• D. Limit fluid intake

Correct answer: A

Rationale: The correct answer is A: Administer antihistamines as prescribed. Pruritus, or itching, is a common symptom in clients with cirrhosis. Antihistamines can help relieve itching by blocking the effects of histamine. Applying alcohol-based lotions (choice B) can further dry out the skin and exacerbate itching. Encouraging frequent baths with hot water (choice C) can also worsen pruritus by stripping the skin of natural oils. Limiting fluid intake (choice D) is not directly related to managing pruritus in cirrhosis.

5. Which of the following are key parameters that produce blood pressure? (Select ONE that does not apply)

• A. Heart rate
• B. Stroke volume
• C. Peripheral resistance
• D. Neuroendocrine hormones

Correct answer: D

Rationale: Heart rate, stroke volume, and peripheral resistance are indeed key parameters that directly influence blood pressure. Heart rate refers to the number of times the heart beats per minute, affecting how much blood is pumped. Stroke volume is the amount of blood pumped by the heart in one contraction. Peripheral resistance is the resistance of the arteries to blood flow, impacting the pressure needed to push blood through. Neuroendocrine hormones, while they can indirectly influence blood pressure regulation by affecting factors like blood volume and vascular tone, are not direct final parameters that produce blood pressure.

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