Nursing Elites

1. A nurse is reviewing laboratory results and notes that a client's serum sodium level is 150 mEq/L. The nurse reports the serum sodium level to the physician, and the physician prescribes dietary instructions based on the sodium level. Which food item should the nurse instruct the client to avoid?

• A. Peas
• B. Cauliflower
• C. Low-fat yogurt
• D. Processed oat cereals

Correct answer: D

Rationale: The correct answer is processed oat cereals. Processed oat cereals are often high in sodium content, which should be avoided in cases of hypernatremia. Peas, cauliflower, and low-fat yogurt are generally low in sodium and are not typically contraindicated in hypernatremia. Therefore, choices A, B, and C are incorrect.

2. Which of the following most accurately describes a current concern in health care today?

• A. Health care-associated (nosocomial) infections continue to increase, not limited to health-care settings.
• B. Despite preventable deaths increasing from the opioid crisis, life expectancy in the United States has slightly risen over the last 2 years.
• C. Although adverse drug events persist, medication errors have not been completely eliminated through the use of electronic medication administration records.
• D. Gun violence has become a growing public health concern.

Correct answer: D

Rationale: Gun violence has become a growing public health concern due to the increasing rates of injury and death caused by the misuse of firearms. Choice A is incorrect because health care-associated infections are not limited to health-care settings and continue to increase. Choice B is inaccurate as preventable deaths from the opioid crisis have not led to a rise in life expectancy in the United States. Choice C is incorrect as medication errors have not been completely eliminated despite the use of electronic medication administration records.

3. What is idiopathic thrombocytopenia purpura?

• A. Highly similar to disseminated intravascular coagulation (DIC).
• B. Caused by the overproduction of platelets.
• C. A bleeding disorder that is characterized by too few platelets.
• D. Treated with immune system-boosting medications.

Correct answer: C

Rationale: Idiopathic thrombocytopenic purpura is a bleeding disorder characterized by a low number of platelets in the blood. This condition is not highly similar to disseminated intravascular coagulation (DIC), which involves abnormal clotting throughout the body (coagulation), leading to depletion of platelets. Choice B is incorrect because idiopathic thrombocytopenic purpura is actually characterized by a decrease in platelet count, not an overproduction. While immune system-boosting medications may be used in some cases, the primary treatment for idiopathic thrombocytopenic purpura focuses on increasing platelet counts or managing symptoms.

4. Which insulin has the most rapid onset of action?

• A. Lente
• B. Lispro
• C. Ultralente
• D. Humulin N

Correct answer: B

Rationale: Lispro insulin has the most rapid onset of action among the options provided. It is a rapid-acting insulin analog that is designed to control postprandial hyperglycemia effectively. Lente insulin (Choice A) and Ultralente insulin (Choice C) are intermediate-acting insulins, which have a slower onset of action compared to Lispro. Humulin N (Choice D) is a neutral protamine Hagedorn (NPH) insulin, which is an intermediate-acting insulin, not rapid-acting like Lispro. Therefore, the correct choice is Lispro.

5. Which of the following methods of insulin administration would be used in the initial treatment of hyperglycemia in a client with diabetic ketoacidosis?

• A. Subcutaneous
• B. Intramuscular
• C. IV bolus only
• D. IV bolus, followed by continuous infusion

Correct answer: D

Rationale: The correct answer is D: IV bolus, followed by continuous infusion. In the initial treatment of hyperglycemia in a client with diabetic ketoacidosis, insulin is administered via IV bolus to quickly reduce blood glucose levels, followed by a continuous infusion to maintain control. Subcutaneous and intramuscular routes are not used in this situation as they are not rapid or predictable enough to address the acute hyperglycemia seen in diabetic ketoacidosis. IV bolus alone without the continuous infusion may not provide sustained control of blood glucose levels, making choice C incorrect.

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