Nursing Elites

1. A client with diabetes mellitus is being taught by a nurse about managing blood glucose levels. Which of the following client statements indicates an understanding of the teaching?

• A. I will eat a snack if my blood glucose level is below 70 mg/dL.
• B. I will take my insulin if my blood glucose level is above 200 mg/dL.
• C. I will check my blood glucose level once a week.
• D. I will take my insulin only when I feel symptoms of hyperglycemia.

Correct answer: A

Rationale: Choice A is the correct answer because consuming a snack when the blood glucose level is below 70 mg/dL helps prevent hypoglycemia in clients with diabetes mellitus. Choice B is incorrect because taking insulin when blood glucose is high (above 200 mg/dL) helps manage hyperglycemia, not hypoglycemia. Choice C is incorrect as checking blood glucose levels once a week is insufficient for proper diabetes management, which typically requires more frequent monitoring. Choice D is incorrect because waiting for symptoms of hyperglycemia to take insulin can lead to uncontrolled blood glucose levels.

2. A nurse is caring for a client who has acute pancreatitis. Which of the following laboratory findings should the nurse expect to be elevated?

• A. Hemoglobin
• B. Bilirubin
• C. Amylase
• D. Creatinine

Correct answer: C

Rationale: The correct answer is C: Amylase. Amylase levels are elevated in clients with acute pancreatitis due to inflammation of the pancreas. Elevated hemoglobin (choice A) is not typically associated with acute pancreatitis. Bilirubin (choice B) may be elevated in conditions affecting the liver, not specifically in acute pancreatitis. Creatinine (choice D) is a marker of kidney function and is not directly related to acute pancreatitis.

3. A nurse is caring for a client who has a prescription for digoxin. Which of the following laboratory values should the nurse monitor to identify an adverse effect of this medication?

• A. Potassium 3.5 mEq/L
• B. Sodium 140 mEq/L
• C. Calcium 9.5 mg/dL
• D. Magnesium 2.0 mEq/L

Correct answer: A

Rationale: The correct answer is A: Potassium 3.5 mEq/L. Digoxin can cause hypokalemia as an adverse effect. Monitoring potassium levels is crucial because low potassium levels can increase the risk of digoxin toxicity. Choices B, C, and D are incorrect as they are not directly associated with potential adverse effects of digoxin. Sodium levels are not typically affected by digoxin, calcium levels are not a primary concern with digoxin therapy, and magnesium levels are not the most important to monitor for digoxin adverse effects.

4. A nurse is caring for a client who has chronic kidney disease and a serum potassium level of 6.0 mEq/L. Which of the following findings should the nurse expect?

• A. Hypokalemia
• B. Hypocalcemia
• C. Hypoglycemia
• D. Hyperkalemia

Correct answer: D

Rationale: The correct answer is D: Hyperkalemia. In chronic kidney disease, there is decreased renal excretion of potassium, leading to elevated serum potassium levels. Hypokalemia (Choice A) is low potassium levels, which is the opposite finding in this scenario. Hypocalcemia (Choice B) is decreased calcium levels and is not directly related to chronic kidney disease or elevated potassium levels. Hypoglycemia (Choice C) is low blood sugar levels and is not typically associated with chronic kidney disease or high potassium levels.

5. A nurse is caring for a client who is in labor and has an external fetal monitor in place. The nurse observes late decelerations in the fetal heart rate. Which of the following findings should the nurse identify as the cause of late decelerations?

• A. Fetal head compression
• B. Uteroplacental insufficiency
• C. Umbilical cord compression
• D. Fetal hypoxia

Correct answer: B

Rationale: Late decelerations in the fetal heart rate are caused by uteroplacental insufficiency, which results from inadequate blood flow to the placenta. This leads to reduced oxygen and nutrients reaching the fetus during contractions. Choice A, fetal head compression, does not typically cause late decelerations but can result in variable decelerations. Choice C, umbilical cord compression, usually leads to variable decelerations. Choice D, fetal hypoxia, is a broad term and not the direct cause of late decelerations, which are specifically linked to uteroplacental insufficiency.

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