Nursing Elites

1. A nurse is providing teaching to a client who has diabetes mellitus and a new prescription for insulin glargine. Which of the following instructions should the nurse include?

• A. You should inject this medication once a day, at the same time each day.
• B. You should expect your blood glucose level to increase immediately after administration.
• C. You should rotate injection sites between your abdomen and thigh.
• D. You should inject this medication with your meals.

Correct answer: A

Rationale: The correct instruction that the nurse should include is to inject insulin glargine once a day, at the same time each day. Insulin glargine is a long-acting insulin that provides a consistent level of insulin over 24 hours, helping to maintain stable blood glucose levels. Option B is incorrect because insulin glargine does not cause an immediate increase in blood glucose levels. Option C is important for preventing lipodystrophy but is not specific to insulin glargine administration. Option D is incorrect because insulin glargine is typically administered at the same time each day, regardless of meals.

2. A nurse is assessing a client who has chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse report to the provider?

• A. Oxygen saturation of 91%
• B. Use of pursed-lip breathing
• C. Productive cough with green sputum
• D. Decreased breath sounds in the right lower lobe

Correct answer: D

Rationale: The correct finding the nurse should report to the provider is decreased breath sounds in the right lower lobe. This can indicate a respiratory infection or atelectasis in clients with COPD, requiring further evaluation and intervention. Choice A, an oxygen saturation of 91%, although slightly lower than normal, does not necessarily require immediate reporting unless the client's baseline is significantly higher. Choice B, the use of pursed-lip breathing, is actually a beneficial technique for clients with COPD to improve oxygenation and reduce shortness of breath, so it does not need reporting. Choice C, a productive cough with green sputum, can be common in clients with COPD and may indicate an infection, but it is not as concerning as decreased breath sounds in a specific lung lobe which may signify a more acute issue.

3. A nurse is providing teaching to a client who has irritable bowel syndrome (IBS). Which of the following dietary recommendations should the nurse make?

• A. Increase your intake of high-fiber foods.
• B. Avoid foods that are high in fat.
• C. Increase your intake of dairy products.
• D. Drink carbonated beverages to help with bloating.

Correct answer: B

Rationale: The correct answer is B: "Avoid foods that are high in fat." Clients with IBS should avoid foods high in fat as they can exacerbate symptoms such as abdominal pain, bloating, and diarrhea. High-fiber foods, choice A, can sometimes worsen symptoms in individuals with IBS. Increasing intake of dairy products, choice C, may also worsen symptoms for some individuals with IBS, especially if they are lactose intolerant. Drinking carbonated beverages, choice D, can contribute to bloating and gas, making symptoms worse for individuals with IBS.

4. A nurse in a provider's office is reviewing the laboratory results of a group of clients. The nurse should identify that which of the following sexually transmitted infections is a nationally notifiable infectious disease that should be reported to the state health department?

• A. Chlamydia
• B. Human papillomavirus
• C. Candidiasis
• D. Herpes simplex virus

Correct answer: A

Rationale: Chlamydia is the correct answer. It is a sexually transmitted infection that is nationally notifiable, meaning healthcare providers are required to report cases to the state health department. This is crucial for disease surveillance, monitoring, and implementing public health interventions. Human papillomavirus, Candidiasis, and Herpes simplex virus are not nationally notifiable infectious diseases and do not require mandatory reporting to the state health department.

5. What is the appropriate action for a patient experiencing chest pain?

• A. Administer aspirin
• B. Reposition the patient
• C. Check oxygen saturation
• D. Prepare for surgery

Correct answer: A

Rationale: The correct action for a patient experiencing chest pain is to administer aspirin. Aspirin helps reduce the risk of clot formation in patients with chest pain, as it has antiplatelet effects. Repositioning the patient may not address the underlying cause of the chest pain. Checking oxygen saturation is important but not the initial priority in this scenario. Surgery is not typically the first-line treatment for chest pain without further assessment and diagnostic procedures.

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