Nursing Elites

1. When implementing patient teaching for a patient admitted with hyperglycemia and newly diagnosed diabetes mellitus scheduled for discharge the second day after admission, what is the priority action for the nurse?

• A. Instruct about the increased risk of cardiovascular disease.
• B. Provide detailed information about dietary glucose control.
• C. Teach glucose self-monitoring and medication administration.
• D. Give information about the effects of exercise on glucose control.

Correct answer: C

Rationale: The priority action for the nurse when time is limited is to focus on essential teaching. In this scenario, the patient should be educated on how to self-monitor glucose levels and administer medications to control glucose levels. This empowers the patient with immediate skills for managing their condition. Instructing about the increased risk of cardiovascular disease (choice A) is important but not as urgent as teaching self-monitoring and medication administration. Providing detailed information about dietary glucose control (choice B) can be beneficial but is secondary to ensuring the patient can monitor and manage their glucose levels. Teaching about the effects of exercise (choice D) is relevant but not as critical as immediate self-monitoring and medication administration education.

2. A client is being treated with an antidepressant for major depressive disorder. Which statement by the client indicates a need for further teaching?

• A. I know it may take several weeks before I start feeling better.
• B. I should avoid drinking alcohol while taking this medication.
• C. I will stop taking the medication as soon as I feel better.
• D. I should take the medication at the same time every day.

Correct answer: C

Rationale: Choice C indicates a need for further teaching because stopping antidepressants abruptly can lead to withdrawal symptoms. It is essential for the client to follow the healthcare provider's instructions and complete the full course of medication even if they start feeling better to prevent potential relapse or withdrawal effects.

3. Why is a low-protein diet recommended for a client with hepatic encephalopathy?

• A. Hyperglycemia
• B. Hypoglycemia
• C. Increased ammonia levels
• D. Electrolyte imbalance

Correct answer: C

Rationale: A low-protein diet is recommended for clients with hepatic encephalopathy to reduce ammonia levels. Ammonia, a byproduct of protein metabolism, can accumulate in the blood due to impaired liver function. Elevated ammonia levels can lead to worsening hepatic encephalopathy, a condition characterized by cognitive and neurological disturbances. Therefore, by limiting protein intake, the production of ammonia is reduced, thereby helping to manage hepatic encephalopathy. Choices A, B, and D are incorrect because hepatic encephalopathy is not primarily related to hyperglycemia, hypoglycemia, or electrolyte imbalance. The focus is on reducing ammonia levels to improve the condition.

4. The nurse is providing an educational workshop about coronary artery disease (CAD) and its risk factors. The nurse explains to participants that CAD has many risk factors, some that can be controlled and some that cannot. What risk factors should the nurse list that can be controlled or modified?

• A. Gender, obesity, family history, and smoking
• B. Inactivity, stress, gender, and smoking
• C. Cholesterol levels, hypertension, and smoking
• D. Stress, family history, and obesity

Correct answer: C

Rationale: Cholesterol levels, hypertension, and smoking are controllable risk factors for CAD. Managing these factors through lifestyle changes and medical interventions can help reduce the risk of developing coronary artery disease.

5. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy. Which intervention should the nurse implement to ensure the client's safety?

• A. Increase the oxygen flow rate to 6 liters/minute if the client is short of breath.
• B. Instruct the client to breathe deeply and cough frequently.
• C. Use a nasal cannula to deliver oxygen at a low flow rate.
• D. Encourage the client to remove the oxygen when eating or drinking.

Correct answer: C

Rationale: Using a nasal cannula to deliver oxygen at a low flow rate is the appropriate intervention for clients with COPD receiving oxygen therapy. High flow rates can lead to respiratory depression in COPD patients. This intervention helps maintain a safe and controlled oxygen delivery to prevent potential complications associated with high oxygen flow rates.

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