Nursing Elites

1. When planning care for a client with vision loss, which of the following interventions should the nurse include in the plan of care to assist the client with feeding?

• A. Arrange food in a consistent pattern on the client's plate
• B. Thicken liquids on the client's tray
• C. Provide small-handled utensils for the client
• D. Assign a staff member to feed the client

Correct answer: A

Rationale: When a client has vision loss, arranging food in a consistent pattern on the plate can help them locate and identify different food items more easily. This intervention promotes independence and allows the client to feed themselves with greater ease. Thicking liquids on the tray, providing small-handled utensils, or assigning a staff member to feed the client may not directly address the client's need for assistance with feeding due to vision loss. Thicking liquids is more related to swallowing difficulties, providing small-handled utensils can be helpful for clients with limited dexterity, and assigning a staff member to feed the client may not promote independence.

2. For a 55-year-old female patient with type 2 diabetes and a nursing diagnosis of imbalanced nutrition: more than body requirements, which goal is most important?

• A. The patient will reach a glycosylated hemoglobin level of less than 7%.
• B. The patient will follow a diet and exercise plan that results in weight loss.
• C. The patient will choose a diet that distributes calories throughout the day.
• D. The patient will state the reasons for eliminating simple sugars in the diet.

Correct answer: A

Rationale: The most important goal for a 55-year-old female patient with type 2 diabetes and imbalanced nutrition due to more than body requirements is to reach a glycosylated hemoglobin level of less than 7%. This goal directly addresses the management of diabetes and is crucial in preventing complications associated with high blood sugar levels. Choice B focuses on weight loss, which may be beneficial but is not as critical as controlling blood sugar levels. Choice C, distributing calories throughout the day, is important for glycemic control but not as immediate as reaching a target HbA1c level. Choice D, stating the reasons for eliminating simple sugars, is a good educational goal but not as urgent as achieving glycemic control.

3. A nurse manager is preparing the budget for the year. The budgeted amounts have been set without regard to changes that may occur during the year. What type of budget is the manager preparing?

• A. Fixed budget
• B. Zero-based budget
• C. Variable budget
• D. Operating budget

Correct answer: A

Rationale: The correct answer is A: Fixed budget. A fixed budget is one where the budgeted amounts are set without considering changes that may occur during the year. This type of budget is based on the assumption that the business environment will remain stable. Choice B, Zero-based budget, involves setting the budget at zero and justifying all expenses. Choice C, Variable budget, adjusts based on changes in activity levels. Choice D, Operating budget, is a comprehensive projection of all revenue and expenses for the upcoming period.

4. A client is having difficulty breathing while receiving supplemental oxygen via a nasal cannula in a supine position. Which of the following interventions should the nurse take first?

• A. Suction the client's airway.
• B. Instruct the client to perform incentive spirometry every hour.
• C. Assist the client to an upright position.
• D. Humidify the client's supplemental oxygen.

Correct answer: C

Rationale: When a client is experiencing difficulty breathing, the priority intervention is to assist the client to an upright position. This position helps improve ventilation by maximizing lung expansion and promoting better oxygenation. Suctioning the airway may be necessary if there is an obstruction, but repositioning the client is the initial step. Instructing the client to perform incentive spirometry and humidifying oxygen are important interventions but not the first priority in this scenario.

5. A 32-year-old patient with diabetes is starting on intensive insulin therapy. Which type of insulin will the nurse discuss using for mealtime coverage?

• A. Lispro (Humalog)
• B. Glargine (Lantus)
• C. Detemir (Levemir)
• D. NPH (Humulin N)

Correct answer: A

Rationale: For mealtime coverage in intensive insulin therapy, rapid-acting insulins like Lispro (Humalog) are used. Lispro has a quick onset of action, making it suitable for covering the rise in blood sugar levels after meals. Glargine (Lantus), Detemir (Levemir), and NPH (Humulin N) are all long-acting insulins and are not appropriate for mealtime coverage as they do not act quickly enough to manage postprandial glucose spikes.

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