Nursing Elites

1. A nurse is preparing discharge information for a client who has type 2 diabetes mellitus. Which of the following resources should the nurse provide to the client?

• A. Personal blogs about managing the adverse effects of diabetes medications.
• B. Food label recommendations from the Institute of Medicine.
• C. Diabetes medication information from the Physicians' Desk Reference.
• D. Food exchange lists for meal planning from the American Diabetes Association.

Correct answer: D

Rationale: The correct answer is D. Food exchange lists from the American Diabetes Association are valuable resources for individuals with diabetes as they provide specific guidance on meal planning and portion control, which are crucial for managing blood sugar levels. Choice A is incorrect because personal blogs may not always provide accurate or evidence-based information. Choice B is incorrect as food label recommendations, while important, may not offer the structured guidance needed for meal planning in diabetes. Choice C is also incorrect as medication information is different from dietary guidance needed for diabetes management.

2. A nurse is reviewing the plan of care for a client who is in the manic phase of bipolar disorder. Which of the following interventions should the nurse expect to include?

• A. Encourage group activities to promote socialization.
• B. Encourage the client to take frequent naps throughout the day.
• C. Provide the client with frequent high-calorie snacks.
• D. Promote physical activity during mealtimes to stimulate appetite.

Correct answer: C

Rationale: Providing high-calorie snacks is essential when caring for a client in the manic phase of bipolar disorder because they often have increased energy expenditure and may not eat adequately due to their heightened activity levels. Encouraging group activities (Choice A) may overwhelm the client further during this phase. Encouraging frequent naps (Choice B) contradicts the need to manage increased energy levels. Promoting physical activity during mealtimes (Choice D) may not be appropriate as it can distract the client from eating, which is crucial in meeting their nutritional needs.

3. A nurse is caring for a client who has bipolar disorder and is experiencing acute mania. The nurse obtained a verbal prescription for restraints. Which of the following actions should the nurse take?

• A. Request a renewal of the prescription every 8 hours.
• B. Check the client's peripheral pulse rate every 30 minutes.
• C. Obtain a prescription for restraint within 4 hours.
• D. Document the client's condition every 15 minutes.

Correct answer: C

Rationale: Obtaining a prescription for restraint within 4 hours is the correct action when managing restraints in a client with acute mania. This timeframe ensures that the use of restraints is promptly evaluated and authorized by a healthcare provider. Requesting a renewal of the prescription every 8 hours (Choice A) is not necessary and may delay appropriate care. Checking the client's peripheral pulse rate every 30 minutes (Choice B) is important but not the immediate priority when dealing with obtaining a prescription for restraints. Documenting the client's condition every 15 minutes (Choice D) is essential for monitoring, but the priority is to secure a prescription for restraints promptly.

4. A nurse is preparing to administer a unit of packed RBCs to a client. Which of the following actions should the nurse take?

• A. Prime the IV tubing with 0.9% sodium chloride.
• B. Verify the client's blood type and Rh factor.
• C. Administer the blood over 8 hours.
• D. Use a 22-gauge needle for venous access.

Correct answer: B

Rationale: The correct answer is to verify the client's blood type and Rh factor. This action is crucial to ensure that the correct blood is administered, matching the client's blood type and Rh factor, which helps prevent transfusion reactions. Priming the IV tubing with 0.9% sodium chloride (Choice A) is not directly related to ensuring the correct blood product is administered. Administering the blood over 8 hours (Choice C) is not the standard practice for packed RBCs, which are usually given over a shorter period. Using a 22-gauge needle for venous access (Choice D) is not specific to the preparation for administering packed RBCs.

5. A nurse is reviewing the medication record of a client with chronic kidney disease. Which of the following medications should the nurse question?

• A. Calcium carbonate
• B. Furosemide
• C. Epoetin alfa
• D. Spironolactone

Correct answer: D

Rationale: The correct answer is D, Spironolactone. Spironolactone is a potassium-sparing diuretic, which may lead to hyperkalemia in clients with chronic kidney disease. Therefore, its use should be questioned in this population. Choice A, Calcium carbonate, is commonly used to manage phosphate levels in chronic kidney disease. Choice B, Furosemide, is a loop diuretic that helps with fluid retention but should be used with caution in kidney disease. Choice C, Epoetin alfa, is a medication used to stimulate red blood cell production in clients with chronic kidney disease and anemia.

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