Nursing Elites

1. A client with DM is scheduled for surgery. The nurse should plan to:

• A. Monitor the client's blood glucose level closely during the perioperative period.
• B. Give the client a regular diet as ordered.
• C. Have the client stop taking insulin 48 hours before surgery.
• D. Hold the client's insulin on the morning of surgery.

Correct answer: A

Rationale: The correct answer is to monitor the client's blood glucose level closely during the perioperative period. For a client with diabetes mellitus (DM) scheduled for surgery, it is essential to closely monitor blood glucose levels to prevent hypo- or hyperglycemia. Choice B is incorrect because giving the client a regular diet as ordered may not address the specific needs related to managing blood glucose levels in the perioperative period. Choice C is incorrect as abruptly stopping insulin 48 hours before surgery can lead to uncontrolled blood sugar levels, which is not recommended. Choice D is incorrect because holding the client's insulin on the morning of surgery can also disrupt blood sugar control, potentially leading to complications during the perioperative period.

2. A client with Cushing's syndrome is scheduled for surgery to remove an adrenal tumor. The nurse should monitor for which of the following complications postoperatively?

• A. Hyperglycemia
• B. Hypotension
• C. Hypokalemia
• D. Hyponatremia

Correct answer: B

Rationale: Postoperative hypotension is a common complication after adrenal tumor removal in a client with Cushing's syndrome. This occurs due to the sudden withdrawal of cortisol, which leads to a relative adrenal insufficiency state. Hyperglycemia (Choice A) is more common preoperatively due to excessive cortisol levels. Hypokalemia (Choice C) and Hyponatremia (Choice D) are also associated with Cushing's syndrome but are less likely to be immediate postoperative complications compared to hypotension.

3. A client with type 1 diabetes mellitus presents with nausea, vomiting, and abdominal pain. The nurse suspects diabetic ketoacidosis (DKA). Which of the following lab findings would confirm this diagnosis?

• A. Serum glucose of 180 mg/dL
• B. Serum bicarbonate of 22 mEq/L
• C. Blood pH of 7.25
• D. Urine specific gravity of 1.020

Correct answer: C

Rationale: A blood pH of 7.25 is a critical finding in diabetic ketoacidosis (DKA) as it indicates metabolic acidosis, which is a hallmark of this condition. In DKA, there is an accumulation of ketones in the blood, leading to increased acidity. The serum glucose level is typically elevated in DKA, often exceeding 250 mg/dL. A serum bicarbonate level less than 18 mEq/L is usually seen in DKA due to the metabolic acidosis. Urine specific gravity is not a specific indicator for DKA and may vary depending on the individual's hydration status. Therefore, the correct lab finding that confirms DKA in this scenario is a blood pH of 7.25.

4. Which of the following is true about nursing ethics?

• A. Nursing ethics focus on the organizational level at the workplace.
• B. Nursing ethics focus on the moral character of nurses.
• C. Nursing ethics focus on the experiences and needs of patients.
• D. Nursing ethics focus on the ethical principles governing healthcare organizations.

Correct answer: B

Rationale: The correct answer is B. Nursing ethics primarily focus on the moral character of nurses, emphasizing principles, values, and virtues that guide their professional conduct. Choice A is incorrect as nursing ethics are more about individual moral decision-making than organizational practices. Choice C is incorrect because while nurses consider patients' experiences and needs, nursing ethics primarily revolve around the nurses themselves. Choice D is incorrect as nursing ethics are centered on the moral obligations and responsibilities of nurses, not specifically on the ethical principles governing healthcare organizations.

5. Which of the following statements is true regarding followership and leadership?

• A. Effective leadership is more important than followership.
• B. Good leaders do not need to be good followers.
• C. A good follower is not just skilled but also self-directed.
• D. Critical thinking is only required for effective leadership.

Correct answer: C

Rationale: The correct answer is C: 'A good follower is not just skilled but also self-directed.' This statement is true as being self-directed complements effective leadership. Good followers possess the ability to take initiative, work independently, and contribute positively to a team without constant supervision. Option A is incorrect because followership is equally important as leadership in achieving group success. Option B is incorrect as good leaders often demonstrate qualities of good followership, such as being able to listen, collaborate, and support others. Option D is incorrect because critical thinking is essential for both effective leadership and followership, not exclusively for leadership roles.

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