Nursing Elites

1. A nurse is preparing to teach a client about the management of hypoglycemia. Which sign should the nurse instruct the client to monitor for?

• A. Diaphoresis
• B. Polyuria
• C. Abdominal pain
• D. Thirst

Correct answer: A

Rationale: The correct answer is A: Diaphoresis. Diaphoresis, which refers to excessive sweating, is a classic symptom of hypoglycemia. Instructing the client to monitor for diaphoresis is crucial as it can help them recognize and address hypoglycemic events promptly. Polyuria (excessive urination), abdominal pain, and thirst are not typical signs of hypoglycemia. Polyuria is more commonly associated with conditions like diabetes mellitus, while abdominal pain and thirst are not specific indicators of low blood sugar levels.

2. A nurse is providing discharge teaching for a client who has COPD about nutrition. Which of the following instructions should the nurse include?

• A. Eat three large meals daily
• B. Consume high-calorie, high-protein foods
• C. Limit caffeinated drinks to two per day
• D. Drink fluids between meals

Correct answer: B

Rationale: The correct answer is B: 'Consume high-calorie, high-protein foods.' Clients with COPD often have increased energy needs due to the work of breathing. Consuming high-calorie, high-protein foods can help provide the necessary energy and prevent weight loss. Choice A is incorrect because eating three large meals daily may lead to increased shortness of breath due to a full stomach. Choice C is incorrect because limiting caffeinated drinks is important, but the recommendation should focus on reducing intake, not specifying a number. Choice D is incorrect because drinking fluids during mealtime can lead to early satiety, making it difficult for the client to consume enough calories.

3. A client is being taught about the use of levothyroxine. Which of the following should be included in the teaching?

• A. Take it with food
• B. Take it at the same time every day
• C. It can be stopped suddenly
• D. Monitor for hyperglycemia

Correct answer: B

Rationale: The correct answer is B: 'Take it at the same time every day.' It is important to take levothyroxine consistently at the same time each day to maintain stable thyroid hormone levels. Choice A is incorrect as levothyroxine should be taken on an empty stomach for better absorption. Choice C is incorrect because stopping levothyroxine suddenly can lead to adverse effects due to sudden changes in hormone levels. Choice D is also incorrect as hyperglycemia is not a common side effect associated with levothyroxine.

4. A nurse is using Naegele’s rule to calculate the expected delivery date for a client whose last menstrual period was in October. What is the expected date?

• A. 711
• B. 1011
• C. 411
• D. 1211

Correct answer: A

Rationale: Using Naegele’s rule, to calculate the expected delivery date, you add one year, subtract three months, and add seven days to the first day of the last menstrual period. If the last menstrual period was in October, adding one year gives October of the following year. Subtracting three months gives July, and adding seven days gives the expected delivery date of July 11th. Therefore, the correct answer is 711. Choice B (1011) is incorrect as it doesn't follow Naegele’s rule calculations. Choices C (411) and D (1211) are also incorrect as they do not align with the correct application of Naegele’s rule.

5. A nurse overhears two assistive personnel (APs) discussing a client in a hospital cafeteria, using the client’s name and discussing details of the diagnosis. Which of the following actions should the nurse take first?

• A. Report the APs' behavior to the supervisor
• B. Complete an incident report regarding the APs' conversation
• C. Provide the APs with written documentation on confidentiality
• D. Tell the APs to discontinue their conversation

Correct answer: D

Rationale: The correct action for the nurse to take first is to tell the APs to discontinue their conversation. By stopping the conversation immediately, the nurse addresses the breach of client confidentiality on the spot. This action is crucial to protect the client's privacy and confidentiality. While further steps such as reporting the behavior or providing education on confidentiality may be necessary, the immediate priority is to stop the inappropriate discussion. Reporting the behavior to the supervisor or completing an incident report can come after the immediate issue is addressed. Providing written documentation on confidentiality may be helpful but is not the most urgent action needed in this situation.

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