Nursing Elites

1. A client with type 1 diabetes mellitus has influenza. The nurse should instruct the client to:

• A. Increase the frequency of self-monitoring (blood glucose testing).
• B. Reduce food intake to alleviate nausea.
• C. Discontinue the insulin dose if unable to eat.
• D. Take the normal dose of insulin.

Correct answer: A

Rationale: During illness, individuals with type 1 diabetes mellitus may experience increased insulin requirements due to factors such as stress and the release of counterregulatory hormones. Increasing the frequency of self-monitoring, as stated in choice A, is crucial to closely monitor and adjust insulin doses as needed. Choice B, reducing food intake to alleviate nausea, is incorrect as it may lead to hypoglycemia and does not address the increased insulin needs during illness. Choice C, discontinuing the insulin dose if unable to eat, is dangerous as it can result in uncontrolled hyperglycemia. Choice D, taking the normal dose of insulin, may not be sufficient during illness when insulin requirements are likely elevated.

2. A client with chronic renal failure is on a low-protein diet. Which of the following is the best response by the nurse when the client asks why this diet is necessary?

• A. It reduces the workload on your kidneys.
• B. It helps prevent the buildup of waste products.
• C. It helps maintain electrolyte balance in your body.
• D. It helps prevent dehydration.

Correct answer: B

Rationale: A low-protein diet is necessary for clients with chronic renal failure because it helps prevent the buildup of waste products, such as urea, in the body. Excess protein can lead to the accumulation of waste products that the compromised kidneys may not effectively filter out, further burdening the already impaired renal function. Choices A, C, and D are incorrect because the primary reason for a low-protein diet in chronic renal failure is to reduce the workload on the kidneys by minimizing the production of waste products that can exacerbate the condition, not specifically to reduce kidney workload, maintain electrolyte balance, or prevent dehydration.

3. A client with functional urinary incontinence is being taught by a nurse. Which statement should the nurse include in this client’s teaching?

• A. Clean around your catheter daily with soap and water.
• B. Wash the vaginal weights with a 10% bleach solution after each use.
• C. Informing about available operations to repair your bladder.
• D. Buy slacks with elastic waistbands that are easy to pull down.

Correct answer: D

Rationale: Functional urinary incontinence is not related to bladder issues but rather to difficulties with ambulation or accessing the toilet. The goal is to help the client manage clothing independently. Elastic waistband slacks that are easy to pull down facilitate timely access to the toilet. Choices A and B are unrelated and not applicable to functional urinary incontinence. Choice C is incorrect as surgeries to repair the bladder are not indicated for functional urinary incontinence.

4. What is the most common cause of peptic ulcers?

• A. Helicobacter pylori infection
• B. NSAID use
• C. Excessive alcohol consumption
• D. Stress

Correct answer: A

Rationale: Helicobacter pylori infection is the most common cause of peptic ulcers. This bacterium can weaken the protective mucous coating of the stomach and duodenum, allowing acid to get through to the sensitive lining beneath. NSAID use (Choice B) can also cause peptic ulcers by disrupting the stomach's mucosal barrier. Excessive alcohol consumption (Choice C) and stress (Choice D) can exacerbate and contribute to ulcer formation but are not the primary cause.

5. The nurse is caring for a patient who will receive 10% calcium gluconate to treat a serum potassium level of 5.9 mEq/L. The nurse performs a drug history prior to beginning the infusion. Which drug taken by the patient would cause concern?

• A. Digitalis
• B. Hydrochlorothiazide
• C. Hydrocortisone
• D. Vitamin D

Correct answer: A

Rationale: Calcium gluconate is administered to treat hyperkalemia by reducing myocardial irritability. When given to a patient taking digitalis, it can lead to digitalis toxicity. Digitalis and calcium gluconate both affect cardiac function, and their concomitant use can potentiate adverse effects. Hydrochlorothiazide, Hydrocortisone, and Vitamin D may impact potassium levels, but they do not interact with calcium gluconate in a way that would cause concern for toxicity.

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