Nursing Elites

1. A client with diabetes mellitus who takes a daily dose of NPH insulin has a hard time drawing the insulin into a syringe because he has difficulty seeing the markings on the syringe. To which services does the nurse suggest a referral?

• A. Home care
• B. Occupational therapy
• C. Social services
• D. Physical therapy

Correct answer: B

Rationale: For a client with diabetes mellitus who struggles to draw insulin due to poor vision, the nurse should suggest a referral to home care services. Home care provides various support services, including assistance with insulin administration. In this scenario, a home care nurse can prefill a week's supply of syringes with the correct insulin dose for the client. These syringes can be stored in the client's refrigerator for self-administration. Occupational therapy focuses on helping individuals with activities of daily living, such as using adaptive devices. Social services typically address counseling and financial aspects of care. Physical therapy is geared towards treating physical disabilities or impairments through exercises and techniques.

2. A client with a left arm fracture complains of severe diffuse pain that is unrelieved by pain medication. On further assessment, the nurse notes that the client experiences increased pain during passive motion compared with active motion of the left arm. Based on these assessment findings, which action should the nurse take first?

• A. Contacting the health care provider
• B. Checking if it is time for more pain medication
• C. Encouraging the client to continue active range of motion exercises of the left arm
• D. Repositioning the client for comfort

Correct answer: A

Rationale: The correct answer is to contact the health care provider. The client with early acute compartment syndrome typically complains of severe diffuse pain that is unrelieved by pain medication. Additionally, the affected client experiences greater pain during passive motion compared to active motion. In this situation, it is crucial to notify the health care provider immediately for further evaluation and intervention. Contacting the health care provider is essential to ensure timely diagnosis and appropriate management of the condition. Checking for more pain medication, encouraging active range of motion exercises, or repositioning the client may not address the underlying issue of acute compartment syndrome and could delay necessary interventions. Therefore, the priority action should be to involve the healthcare provider for prompt assessment and treatment.

3. A gastroenterologist should be consulted for clients suffering from:

• A. digestive system diseases
• B. urinary system diseases
• C. female reproductive system diseases
• D. nervous system diseases

Correct answer: A

Rationale: A gastroenterologist specializes in treating diseases and disorders of the digestive system, including the stomach, intestines, liver, and pancreas. Therefore, clients with digestive system diseases should consult a gastroenterologist. Choices B, C, and D are incorrect because urinary system diseases are managed by urologists, female reproductive system diseases by gynecologists, and nervous system diseases by neurologists.

4. In an obstetrical emergency, which of the following actions should the nurse perform first after the baby delivers?

• A. Place extra padding under the mother to absorb blood from the delivery.
• B. Cut the umbilical cord using sterile scissors.
• C. Suction the baby's mouth and nose.
• D. Wrap the baby in a clean blanket to preserve warmth.

Correct answer: C

Rationale: In an obstetrical emergency, the immediate action the nurse should take after the baby delivers is to suction the baby's mouth and nose to ensure the infant can breathe properly. This helps clear any potential obstructions and establish a clear airway. Cutting the umbilical cord (Choice B) and wrapping the baby in a clean blanket (Choice D) are important steps but should come after ensuring the baby's airway is clear. Placing extra padding under the mother (Choice A) is not a priority in this emergency situation as the focus should be on the baby's immediate needs for breathing and airway clearance.

5. The client with a diagnosis of hepatitis is experiencing pruritus. Which would be the most appropriate nursing intervention?

• A. Suggest that the client take warm showers once a day.
• B. Add baby oil to the client's bath water.
• C. Apply powder to the client's skin.
• D. Suggest a cool-water rinse after bathing.

Correct answer: B

Rationale: Pruritus, or itching, in clients with hepatitis can be alleviated by adding moisturizing agents to bath water. Baby oil helps soothe and moisturize the skin, reducing dryness and itching. Warm showers, as in choice A, can be drying to the skin if taken too frequently, making it less suitable than adding oil to the bath water. Applying powder, as mentioned in choice C, can exacerbate dryness rather than alleviate it. Choice D suggests a cool-water rinse after bathing, which can help in retaining moisture and is less drying compared to hot water rinses.

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