Nursing Elites

1. A nurse is teaching a client who has a new diagnosis of diabetes mellitus about managing blood glucose levels. Which of the following client statements indicates an understanding of the teaching?

• A. "I will monitor my blood pressure regularly."
• B. "I will keep my blood glucose level between 200 and 250 mg/dL."
• C. "I will take my insulin at the same time each day."
• D. "I will eat three large meals each day."

Correct answer: C

Rationale: Taking insulin at the same time each day helps maintain stable blood glucose levels and prevent complications.

2. A nurse is caring for a client who has a new prescription for levothyroxine. Which of the following laboratory values should the nurse monitor to determine the effectiveness of the medication?

• A. Calcium
• B. Sodium
• C. Thyroid-stimulating hormone (TSH)
• D. Magnesium

Correct answer: C

Rationale: The correct answer is C: Thyroid-stimulating hormone (TSH). Monitoring TSH levels is crucial to assess the effectiveness of levothyroxine in clients with hypothyroidism. TSH is produced by the pituitary gland and stimulates the thyroid gland to produce thyroid hormones. In hypothyroidism, where the thyroid gland is underactive, administering levothyroxine helps to normalize thyroid hormone levels. Monitoring TSH levels allows the healthcare provider to adjust the levothyroxine dosage to ensure that thyroid hormone levels are within the therapeutic range. Choices A, B, and D (Calcium, Sodium, and Magnesium) are not directly related to assessing the effectiveness of levothyroxine therapy in hypothyroidism and would not provide relevant information regarding the medication's efficacy.

3. What is the most appropriate intervention for a patient experiencing hypoglycemia?

• A. Administer glucagon
• B. Provide oral glucose
• C. Administer IV fluids
• D. Monitor blood sugar levels

Correct answer: B

Rationale: Providing oral glucose is the correct intervention for a patient experiencing hypoglycemia. Oral glucose helps quickly raise blood sugar levels, making it the preferred treatment for mild hypoglycemia. Administering glucagon (Choice A) is usually reserved for severe cases when the patient cannot take anything by mouth. Administering IV fluids (Choice C) is not the primary intervention for hypoglycemia unless the patient is severely dehydrated. Monitoring blood sugar levels (Choice D) is important but providing glucose is the immediate priority to treat hypoglycemia.

4. A client with heart failure at risk for pulmonary edema should receive which intervention to improve oxygenation?

• A. Place the client in a supine position.
• B. Encourage the client to increase fluid intake.
• C. Elevate the client's legs when in bed.
• D. Administer oxygen via non-rebreather mask.

Correct answer: D

Rationale: Administering oxygen via a non-rebreather mask is the appropriate intervention for a client at risk for pulmonary edema as it helps improve oxygenation by delivering a high concentration of oxygen. Placing the client in a supine position can exacerbate pulmonary edema by increasing venous return to the heart, leading to fluid overload. Encouraging increased fluid intake is contraindicated in clients with heart failure and at risk for pulmonary edema, as it can worsen fluid accumulation. Elevating the client's legs when in bed is more appropriate for clients with conditions such as venous insufficiency or edema in the lower extremities, not for pulmonary edema.

5. A nurse is preparing to administer a dose of digoxin to a client who has heart failure. Which of the following actions should the nurse take prior to administering the medication?

• A. Monitor the client's respiratory rate.
• B. Assess the client's apical pulse.
• C. Review the client's potassium level.
• D. Monitor the client's fluid intake.

Correct answer: B

Rationale: The correct action the nurse should take prior to administering digoxin is to assess the client's apical pulse. Digoxin is known to affect the heart rate, potentially causing bradycardia. Monitoring the client's respiratory rate (Choice A) is not directly related to administering digoxin. Reviewing the client's potassium level (Choice C) is important but not a direct prerequisite for administering digoxin. Monitoring the client's fluid intake (Choice D) is also important but not a specific action to take just before administering digoxin.

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