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. A healthcare provider is preparing to administer an intramuscular injection to an adult client. Which of the following injection sites should the healthcare provider select?

• A. Deltoid muscle
• B. Dorsogluteal muscle
• C. Vastus lateralis muscle
• D. Rectus femoris muscle

Correct answer: A

Rationale: The deltoid muscle is a common site for intramuscular injections in adults due to its accessibility and muscle mass. It is located in the upper arm and provides a sufficient area for injection. The deltoid muscle is preferred for administering vaccines and other medications that require IM administration. Choice B, the dorsogluteal muscle, is not recommended for intramuscular injections due to the proximity of major nerves and blood vessels in that area, which can lead to nerve damage or injury. Choice C, the vastus lateralis muscle, is more commonly used for infants and young children, while choice D, the rectus femoris muscle, is not typically used for intramuscular injections in adults.

3. A client with a new prescription for a dry-powder inhaler (DPI) is receiving teaching from a healthcare provider. Which of the following statements indicates an understanding of the teaching?

• A. I will shake the inhaler before use.
• B. I will take the medication with food.
• C. I will inhale the medication quickly.
• D. I will use a spacer with the inhaler.

Correct answer: C

Rationale: Choosing option C, 'I will inhale the medication quickly,' demonstrates an understanding of DPI use. Inhaling the medication quickly ensures effective delivery of the dry powder to the lungs, maximizing its therapeutic effects. Options A, B, and D are incorrect as shaking the DPI, taking it with food, and using a spacer are not recommended practices for DPI administration. Shaking a DPI can cause clumping or uneven dispersion of the medication, taking it with food may not affect its efficacy but can increase the risk of side effects, and using a spacer is not necessary for DPIs which are breath-actuated and do not require coordination with inhalation through a spacer.

4. What is the primary benefit of using electronic health records (EHRs) in healthcare?

• A. EHRs eliminate the need for paper records.
• B. EHRs ensure complete patient confidentiality.
• C. EHRs improve the accuracy of patient information.
• D. EHRs reduce the time spent on documentation.

Correct answer: C

Rationale: The primary benefit of using electronic health records (EHRs) in healthcare is that they improve the accuracy and completeness of patient information. By utilizing EHRs, healthcare providers have access to more reliable and up-to-date patient data, which leads to better patient care outcomes. This improved accuracy enables healthcare professionals to make better-informed decisions and provide more effective treatments, ultimately enhancing patient safety and quality of care.

5. A client with meningitis is being assessed by a healthcare provider. Which of the following findings should the provider expect?

• A. Negative Brudzinski’s sign.
• B. Flaccid neck muscles.
• C. Petechial rash.
• D. Hypoactive deep tendon reflexes.

Correct answer: C

Rationale: A petechial rash is a characteristic finding in clients with meningitis, indicating small, pinpoint hemorrhages under the skin. This rash results from the infection's impact on the blood vessels. Petechiae are important to recognize as they can help differentiate meningitis from other conditions with similar symptoms. Brudzinski’s sign, neck stiffness, and positive Kernig’s sign are more common physical exam findings in meningitis. Flaccid neck muscles and hypoactive deep tendon reflexes are not typically associated with meningitis.

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