Nursing Elites

1. A client with type 1 diabetes mellitus is admitted to the hospital with diabetic ketoacidosis (DKA). Which of the following interventions should the nurse implement first?

• A. Administer intravenous insulin
• B. Start an intravenous line and infuse normal saline
• C. Monitor serum potassium levels
• D. Obtain an arterial blood gas (ABG)

Correct answer: B

Rationale: The correct first intervention in the treatment of a client with diabetic ketoacidosis (DKA) is to start an intravenous line and infuse normal saline. This is essential for fluid resuscitation to restore intravascular volume and improve perfusion. Administering intravenous insulin can lead to further potassium depletion without first addressing dehydration and electrolyte imbalances. Monitoring serum potassium levels is important but should follow fluid resuscitation to avoid life-threatening hypokalemia. Obtaining an arterial blood gas (ABG) is necessary to assess the acid-base status but is not the initial priority when managing DKA.

2. A client at risk for hypokalemia is being instructed by a nurse about foods high in potassium that should be included in the daily diet. The nurse determines that the client understands the food sources of potassium if the client states that the food item lowest in potassium is:

• A. Apples
• B. Carrots
• C. Spinach
• D. Avocado

Correct answer: A

Rationale: The correct answer is 'Apples.' Apples are the lowest in potassium among the given options. Carrots, spinach, and avocados are all higher in potassium content compared to apples. Carrots and spinach are vegetables known to have a moderate amount of potassium. Avocados, on the other hand, are a high-potassium fruit and would not be the lowest in potassium among the choices provided.

3. A new nurse is working on becoming a better follower. Which of the following recommendations should she implement?

• A. When you disagree with the manager, seek to determine the manager’s rationale.
• B. Share what you have learned only with newer nurses.
• C. Listen and reflect on your manager’s feedback.
• D. Seek to find a balance and manage your time and energy as you seek to learn about your specialty.

Correct answer: C

Rationale: Listening and reflecting on the manager’s feedback is crucial for a new nurse aiming to become a better follower. It allows the nurse to understand expectations, identify areas for improvement, and show respect for the manager's guidance. Choice A is incorrect as it focuses on resolving disagreements rather than improving followership skills. Choice B is incorrect as knowledge sharing should not be limited to specific groups. Choice D is incorrect as it addresses time management and learning about the specialty, which are important but not directly related to followership development.

4. The healthcare provider is assessing a client with hypothyroidism. Which of the following symptoms would the provider expect to find?

• A. Weight loss
• B. Heat intolerance
• C. Bradycardia
• D. Diarrhea

Correct answer: C

Rationale: Bradycardia is a common symptom of hypothyroidism because the condition leads to a decreased metabolic rate. Weight loss (Choice A) is more commonly associated with hyperthyroidism, where the metabolic rate is increased. Heat intolerance (Choice B) is also more indicative of hyperthyroidism due to increased sensitivity to heat. Diarrhea (Choice D) is not a typical symptom of hypothyroidism; rather, constipation is more common due to the slow-down of the digestive system.

5. How often should rotation sites for insulin injection be separated from one another?

• A. Every third day.
• B. Every week.
• C. Every 2-3 weeks.
• D. Every 2-4 weeks.

Correct answer: C

Rationale: Insulin injection sites should be rotated every 2-3 weeks to prevent lipodystrophy and ensure proper insulin absorption. Option A ('Every third day') is too frequent and does not allow enough time for the previous site to heal properly. Option B ('Every week') might not provide adequate time for the tissue to recover. Option D ('Every 2-4 weeks') could potentially lead to overuse of a single injection site, increasing the risk of lipodystrophy and inconsistent insulin absorption. Therefore, the recommended interval of every 2-3 weeks is optimal for insulin injection site rotation.

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