Nursing Elites

1. When teaching a male client diagnosed with type 1 diabetes mellitus how diet and exercise affect insulin requirements, Nurse Joy should include which guideline?

• A. You'll need more insulin when you exercise or increase your food intake.
• B. You'll need less insulin when you exercise or reduce your food intake.
• C. You'll need less insulin when you increase your food intake.
• D. You'll need more insulin when you exercise or decrease your food intake.

Correct answer: B

Rationale: When a person with type 1 diabetes exercises, it typically lowers blood glucose levels. As a result, insulin needs are reduced when exercise or food intake is decreased. Choice A is incorrect because more insulin is not typically needed when exercise or food intake is increased. Choice C is incorrect because increasing food intake would generally require more insulin to cover the additional glucose from the food. Choice D is incorrect as decreasing food intake usually leads to a lower need for insulin.

2. The client with hyperthyroidism is receiving propylthiouracil (PTU). The nurse should monitor for which of the following potential side effects?

• A. Leukopenia
• B. Hyperglycemia
• C. Hypertension
• D. Weight gain

Correct answer: A

Rationale: The correct answer is A: Leukopenia. Propylthiouracil can lead to bone marrow suppression, resulting in leukopenia. Monitoring white blood cell counts is crucial to detect this potential side effect early. Choice B, hyperglycemia, is not typically associated with propylthiouracil use. Choice C, hypertension, is not a common side effect of propylthiouracil. Choice D, weight gain, is also not a typical side effect of propylthiouracil therapy.

3. A male client with type 1 diabetes mellitus asks the nurse about taking an oral antidiabetic agent. Nurse Jack explains that these medications are only effective if the client:

• A. Prefers to take insulin orally.
• B. Has type 2 diabetes.
• C. Has type 1 diabetes.
• D. Is pregnant and has type 2 diabetes.

Correct answer: B

Rationale: Oral antidiabetic agents are specifically designed for type 2 diabetes mellitus. Type 1 diabetes requires insulin therapy as the primary treatment due to the absence of endogenous insulin production. Therefore, these medications are not effective for individuals with type 1 diabetes like the male client in this scenario. Choice A is incorrect as oral antidiabetic agents are not about preference but rather about treatment efficacy. Choice D is incorrect as being pregnant does not impact the effectiveness of oral antidiabetic agents; they are primarily indicated for type 2 diabetes.

4. Which of the following is true about effective leadership?

• A. Leadership traits can be learned through experience and reflection.
• B. Nurses can learn to become good leaders by acting as good leaders and reflecting on leadership qualities they have and those they can improve upon.
• C. Focus on leadership activities required for the day is essential for effective leadership.
• D. Taking advantage of every opportunity to be a leader is crucial, creating those opportunities as often as possible, especially after gaining experience as a nurse.

Correct answer: B

Rationale: Choice B is correct because nurses can develop effective leadership skills by actively engaging as good leaders and reflecting on their existing leadership qualities and areas for improvement. This process of self-assessment and continuous improvement is crucial in becoming a successful leader. Choice A is incorrect as leadership traits can be learned through experience and reflection rather than being impossible to acquire from a book. Choice C is incorrect as effective leadership involves focusing on long-term goals and strategies, not just daily activities. Choice D is incorrect because while seizing leadership opportunities is important, it should be done strategically and with a solid foundation of experience in nursing to ensure successful leadership outcomes.

5. A healthcare professional is experiencing moral distress due to an ethical dilemma. Which of the following best describes the healthcare professional’s response to this situation?

• A. The healthcare professional is experiencing moral distress because the ethical dilemma is causing a conflict between the healthcare professional’s personal values and professional responsibilities.
• B. The healthcare professional is experiencing moral distress because the ethical dilemma is causing a conflict between the healthcare professional’s obligations to the patient and the healthcare team.
• C. The healthcare professional is experiencing moral distress because the ethical dilemma is causing a conflict between the healthcare professional’s personal beliefs and the expectations of the healthcare organization.
• D. The healthcare professional is experiencing moral distress because the ethical dilemma is causing a conflict between the healthcare professional’s professional judgment and the wishes of the patient’s family.

Correct answer: A

Rationale: Moral distress occurs when a healthcare professional experiences a conflict between personal values and professional responsibilities, leading to emotional and ethical challenges. Choice B is incorrect because moral distress is primarily related to personal values and professional responsibilities, not just obligations to the patient and healthcare team. Choice C is incorrect because moral distress is more about personal values and professional responsibilities, rather than organizational expectations. Choice D is incorrect because moral distress is focused on personal values and professional responsibilities, not just conflicts with the wishes of the patient’s family.

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