Nursing Elites

1. A client with a new diagnosis of diabetes mellitus is receiving teaching from a healthcare provider. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will take my insulin only if my blood sugar is above 200 mg/dL.
• B. I will eat a snack before exercising.
• C. I will avoid all carbohydrates.
• D. I will check my blood sugar once a week.

Correct answer: B

Rationale: Eating a snack before exercising is crucial for managing blood sugar levels and preventing hypoglycemia in individuals with diabetes. Exercising on an empty stomach can lead to low blood sugar levels, but consuming a snack before physical activity helps stabilize blood sugar and provides energy for the body. This proactive approach demonstrates the client's understanding of the importance of managing blood sugar levels during physical activity.

2. What is the primary goal of palliative care?

• A. To cure the client's illness.
• B. To prolong the client's life.
• C. To provide comfort and improve the quality of life.
• D. To prepare the client for surgery.

Correct answer: C

Rationale: The primary goal of palliative care is to provide comfort and improve the quality of life for clients with serious illnesses. Palliative care aims to address physical, emotional, and spiritual needs to enhance overall well-being rather than focusing on curing the underlying illness, prolonging life, or preparing for surgery. It emphasizes symptom management, pain relief, and support for patients and their families to ensure a better quality of life during the course of their illness.

3. A healthcare professional is preparing to administer an intramuscular injection to a client. Which of the following actions should the healthcare professional take?

• A. Use a 1-inch needle.
• B. Stretch the skin at the injection site.
• C. Insert the needle at a 90-degree angle.
• D. Aspirate for blood return before injecting.

Correct answer: D

Rationale: Aspirating for blood return before injecting is a crucial step in administering intramuscular injections. This action ensures that the needle is not in a blood vessel, reducing the risk of injecting medication into a blood vessel, which can lead to potential complications. Choices A, B, and C are incorrect. Using a longer 1-inch needle is often necessary for intramuscular injections to reach the muscle tissue properly. Stretching the skin is not recommended as it can cause unnecessary pain and tissue damage. Inserting the needle at a 90-degree angle is the preferred method for intramuscular injections to ensure proper medication delivery.

4. A nurse is providing discharge teaching to a client who has a prescription for digoxin. Which of the following instructions should the nurse include?

• A. Take your pulse before taking the medication.
• B. Take the medication with an antacid.
• C. Double the dose if you miss one.
• D. Take the medication with a high-fiber meal.

Correct answer: A

Rationale: The correct answer is A: 'Take your pulse before taking the medication.' When administering digoxin, it is crucial to monitor the pulse rate because digoxin can cause bradycardia (slow heart rate). Checking the pulse helps in assessing the heart rate before taking the medication, as bradycardia is a common side effect of digoxin. Choice B is incorrect because digoxin should not be taken with antacids, as they can reduce its absorption. Choice C is incorrect; the dose should never be doubled if a dose is missed. Choice D is incorrect because taking digoxin with a high-fiber meal can also affect its absorption. Therefore, the essential instruction for the client is to monitor the pulse before taking digoxin.

5. A healthcare provider is assessing a client who has fluid volume excess. Which of the following findings should the healthcare provider expect?

• A. Hypotension
• B. Bradycardia
• C. Crackles in the lungs
• D. Dry mucous membranes

Correct answer: C

Rationale: Crackles in the lungs are indicative of fluid accumulation in the alveoli, which is a characteristic finding in clients with fluid volume excess. The crackling sound occurs due to the presence of excess fluid in the lungs, impairing normal ventilation and gas exchange. Monitoring for crackles is essential for early detection and management of fluid overload in clients. Choices A, B, and D are incorrect because in fluid volume excess, hypervolemia leads to increased blood pressure (not hypotension), compensatory tachycardia (not bradycardia), and moist mucous membranes (not dry).

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