Nursing Elites

1. A client with type 2 diabetes mellitus is prescribed metformin. The nurse should monitor the client for which of the following potential side effects?

• A. Lactic acidosis
• B. Hypokalemia
• C. Hyperglycemia
• D. Weight gain

Correct answer: A

Rationale: The correct answer is A, lactic acidosis. Metformin, a common medication for type 2 diabetes mellitus, can lead to lactic acidosis, particularly in individuals with renal impairment or predisposing factors. Monitoring for signs of lactic acidosis, such as muscle pain, weakness, trouble breathing, dizziness, and slow or uneven heart rate, is crucial to prevent serious complications. Choices B, C, and D are incorrect as metformin does not typically cause hypokalemia, hyperglycemia, or weight gain as its primary side effects.

2. When implementing a new policy on the unit, what process should a nurse manager follow?

• A. The nurse manager should involve staff members in the decision-making process, gather input, and communicate the reasons for the policy change to ensure buy-in from the team.
• B. The nurse manager should implement the policy change immediately and monitor staff compliance to ensure that the new policy is being followed.
• C. The nurse manager should delegate the implementation of the policy change to a staff member and provide support as needed to ensure that the change is successful.
• D. The nurse manager should communicate the policy change to staff members, provide training as needed, and monitor the implementation process to ensure that the change is effective.

Correct answer: A

Rationale: When introducing a new policy on the unit, it is essential for the nurse manager to involve staff members in the decision-making process. This approach helps in gathering input and insights from the team, fostering a sense of ownership and commitment. By communicating the reasons behind the policy change, the nurse manager ensures transparency and promotes understanding among the staff, leading to buy-in and acceptance of the new policy. Choice B is incorrect because implementing a policy change without involving staff and explaining the rationale may lead to resistance or lack of understanding. Choice C is not ideal as delegation without active involvement and communication with the team may result in misunderstandings or incomplete implementation. Choice D lacks the crucial step of involving staff in the decision-making process, which is important for successful policy implementation and team engagement.

3. The client with Addison's disease is receiving education on managing the condition. Which of the following instructions should be included?

• A. Increase your sodium intake during periods of stress.
• B. Avoid all types of exercise.
• C. Decrease your fluid intake to prevent fluid overload.
• D. Stop corticosteroid therapy once symptoms improve.

Correct answer: A

Rationale: The correct instruction to include for a client with Addison's disease is to increase sodium intake during periods of stress. In Addison's disease, there is a deficiency of aldosterone leading to sodium loss. Increasing sodium intake helps to compensate for this loss and prevent complications. Choice B is incorrect as exercise is beneficial for overall health but should be done in moderation. Choice C is incorrect as fluid intake should be adequate to prevent dehydration since clients with Addison's disease are prone to electrolyte imbalances. Choice D is incorrect as corticosteroid therapy is essential for managing Addison's disease and should not be discontinued abruptly without medical guidance.

4. A new unit manager works hard to get to know each of the staff members on the unit and determine what each staff member needs in order to effectively do their job. What type of management best describes this manager?

• A. Servant leader-style manager
• B. Networking manager
• C. Coaching manager
• D. Monitoring manager

Correct answer: A

Rationale: A Servant leader-style manager focuses on understanding and meeting the needs of staff members to help them grow and perform at their best. This type of manager prioritizes serving the team and facilitating their development. Networking managers focus on building connections and relationships outside the team. Coaching managers provide guidance, support, and feedback to help employees improve. Monitoring managers primarily oversee and supervise tasks without a strong emphasis on individual needs or growth.

5. Albert, a 35-year-old insulin-dependent diabetic, is admitted to the hospital with a diagnosis of pneumonia. He has been febrile since admission. His daily insulin requirement is 24 units of NPH. Every morning Albert is given NPH insulin at 0730. Meals are served at 0830, 1230, and 1830. The nurse expects that the NPH insulin will reach its maximum effect (peak) between the hours of:

• A. 1130 and 1330.
• B. 1330 and 1930.
• C. 1530 and 2130.
• D. 1730 and 2330.

Correct answer: C

Rationale: NPH insulin typically peaks 4-12 hours after administration, so a peak between 1530 and 2130 would be expected. Choice A (1130 and 1330) is too early for the peak effect of NPH insulin. Choice B (1330 and 1930) falls within the possible peak period but is not as accurate as choice C. Choice D (1730 and 2330) is too late for the peak effect of NPH insulin based on the typical peak timing.

Similar Questions