Nursing Elites

1. A healthcare professional is reviewing the laboratory data of a client who has diabetes mellitus. Which of the following laboratory tests is an indicator of long-term disease management?

• A. Postprandial blood glucose
• B. Glycosylated hemoglobin (HbA1c)
• C. Glucose tolerance test
• D. Fasting blood glucose

Correct answer: B

Rationale: Glycosylated hemoglobin (HbA1c) is the most accurate test for long-term management of blood glucose levels in individuals with diabetes mellitus. HbA1c reflects average blood glucose levels over the past 2-3 months, providing valuable information on the effectiveness of treatment and disease control. Postprandial blood glucose, glucose tolerance test, and fasting blood glucose are essential for monitoring blood glucose levels at specific times but do not offer the same insight into long-term disease management as HbA1c.

2. A client with a new diagnosis of hypertension is being taught by a nurse. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will decrease my potassium intake while taking this medication.
• B. I will need to take medication for the rest of my life.
• C. I will avoid using salt substitutes.
• D. I will avoid drinking grapefruit juice.

Correct answer: C

Rationale: The correct answer is C. Clients with hypertension should avoid salt substitutes because they often contain potassium, which can raise potassium levels. Choice A is incorrect as decreasing potassium intake is not necessary unless advised by a healthcare provider. Choice B is incorrect as not all clients with hypertension need to take medication for life. Choice D is incorrect as grapefruit juice does not significantly impact hypertension management.

3. A nurse is providing discharge teaching to a client who is postoperative following a mastectomy. Which of the following instructions should the nurse include?

• A. Avoid using deodorant until the incision heals.
• B. Perform arm exercises 24 hours after surgery.
• C. Wear tight-fitting clothing to support the incision.
• D. Perform arm exercises 2 days after surgery.

Correct answer: A

Rationale: The correct instruction for the nurse to include is to advise the client to avoid using deodorant until the incision heals. Using deodorant can lead to skin irritation, which should be prevented following a mastectomy. Choice B is incorrect because performing arm exercises should typically be delayed until recommended by the healthcare provider to prevent strain on the surgical site. Choice C is incorrect as tight-fitting clothing can increase discomfort and hinder proper healing. Choice D is also incorrect because initiating arm exercises should be based on the healthcare provider's guidance and not a specific timeframe.

4. A client has a chest tube connected to a water-seal drainage system. Which of the following actions should be taken?

• A. Clamp the chest tube during ambulation
• B. Keep the collection chamber below the level of the chest
• C. Add sterile water to the water-seal chamber
• D. Empty the collection chamber every 12 hours

Correct answer: C

Rationale: The correct action for the nurse to take when caring for a client with a chest tube connected to a water-seal drainage system is to add sterile water to the water-seal chamber. This is necessary to maintain the correct water level for proper chest tube function. Clamping the chest tube during ambulation (Choice A) is incorrect as it can lead to complications by obstructing drainage. Keeping the collection chamber below the level of the chest (Choice B) is incorrect because it should be kept below the chest to facilitate drainage. Emptying the collection chamber every 12 hours (Choice D) is incorrect as it should be emptied whenever it reaches the fill line or as per facility policy, not on a fixed time schedule.

5. A nurse is assessing a client who has hypovolemia. Which of the following findings should the nurse expect?

• A. Bradycardia.
• B. Tachycardia.
• C. Increased blood pressure.
• D. Bounding pulse.

Correct answer: B

Rationale: The correct answer is B: Tachycardia. In hypovolemia, the body responds to decreased fluid volume by increasing the heart rate (tachycardia) to maintain adequate circulation. Bradycardia (Choice A) is not expected in hypovolemia since the heart rate typically increases to compensate for the reduced blood volume. Increased blood pressure (Choice C) is unlikely in hypovolemia as the decreased fluid volume leads to decreased pressure. A bounding pulse (Choice D) is more associated with conditions like hyperthyroidism or fever, not specifically with hypovolemia.

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