Nursing Elites

1. A client with type 1 DM is taught to take NPH and regular insulin every morning. The nurse should provide which instructions to the client?

• A. Take the NPH insulin first, then the regular insulin.
• B. Take the regular insulin first, then the NPH insulin.
• C. It does not matter which insulin is drawn up first.
• D. Contact the healthcare provider if the order for insulin is unclear.

Correct answer: B

Rationale: The correct answer is to take the regular insulin first, then the NPH insulin. Regular insulin should be drawn up before NPH insulin to prevent contamination of the regular insulin vial with the longer-acting insulin. Choice A is incorrect as it suggests taking the NPH insulin first, which is not the recommended practice. Choice C is incorrect because the order of drawing up insulin does matter to prevent contamination. Choice D is not the most appropriate action in this scenario, as the nurse should provide clear instructions to the client based on best practices.

2. A client with Addison's disease is receiving corticosteroid therapy. The nurse should monitor for which of the following potential side effects?

• A. Hypoglycemia
• B. Hyperkalemia
• C. Hyperglycemia
• D. Hyponatremia

Correct answer: C

Rationale: The correct answer is C, Hyperglycemia. Corticosteroid therapy can lead to hyperglycemia by increasing blood glucose levels. Corticosteroids can induce insulin resistance, decrease glucose uptake by tissues, and promote gluconeogenesis. While corticosteroid therapy can cause hypoglycemia in some cases, it is more commonly associated with hyperglycemia. Hyperkalemia (choice B) is more commonly associated with conditions like renal failure or certain medications. Hyponatremia (choice D) is typically not a common side effect of corticosteroid therapy unless there are other contributing factors present.

3. A client with diabetes mellitus is experiencing symptoms of hypoglycemia. Which of the following is the nurse's priority action?

• A. Administer glucagon
• B. Check the client's blood glucose level
• C. Give the client a snack
• D. Notify the healthcare provider

Correct answer: B

Rationale: The correct answer is to check the client's blood glucose level. This is the priority action to confirm hypoglycemia before implementing further interventions. Administering glucagon (Choice A) may be necessary in severe cases of hypoglycemia, but confirming the low blood glucose level is crucial before administering any treatment. Giving the client a snack (Choice C) can help raise blood sugar levels but should come after confirming the hypoglycemia. Notifying the healthcare provider (Choice D) is important, but the immediate priority is to assess and address the hypoglycemia.

4. When should a new nurse graduate consider applying for a position as a nurse manager?

• A. When she is comfortable in her current position
• B. When she begins mentoring other new nurses
• C. As soon as a position opens
• D. When she has developed leadership and clinical expertise

Correct answer: D

Rationale: A new nurse graduate should consider applying for a nurse manager position when they have developed both leadership and clinical expertise. This ensures that they are well-prepared for the responsibilities of the role. Choice A is incorrect because being comfortable in the current position does not necessarily equate to having the required skills for a nurse manager role. Choice B is incorrect as mentoring other new nurses, while valuable, may not directly align with the skills needed for a managerial position. Choice C is incorrect as applying for a nurse manager position solely because a position is available does not guarantee readiness for the role.

5. Why might an RN need professional liability insurance?

• A. Protection against frivolous lawsuits without incurring expenses.
• B. Immunity from being sued by the institution if guilty of malpractice.
• C. Coverage for charges of libel, slander, assault, and HIPAA violations.
• D. Exclusively doctors face malpractice lawsuits.

Correct answer: C

Rationale: Having professional liability insurance is crucial for Registered Nurses due to various reasons. Choice A is incorrect because there are expenses associated with defending against frivolous lawsuits. Choice B is incorrect as institutions can still sue a nurse found guilty of malpractice. Choice D is incorrect because malpractice lawsuits can be filed against healthcare professionals, including nurses. Therefore, the correct answer is C, as liability policies can provide coverage for charges involving libel, slander, assault, and breaches of patient confidentiality like HIPAA violations, offering essential protection for RNs in their practice.

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