Nursing Elites

1. A patient who was admitted with diabetic ketoacidosis secondary to a urinary tract infection has been weaned off an insulin drip 30 minutes ago. The patient reports feeling lightheaded and sweaty. Which action should the nurse take first?

• A. Infuse dextrose 50% by slow IV push.
• B. Administer 1 mg glucagon subcutaneously.
• C. Obtain a glucose reading using a finger stick.
• D. Have the patient drink 4 ounces of orange juice.

Correct answer: C

Rationale: The correct action for the nurse to take first when a patient reports feeling lightheaded and sweaty after being weaned off an insulin drip is to obtain a glucose reading using a finger stick. This will provide crucial information on the patient's current blood glucose level, helping the nurse assess if the symptoms are due to hypoglycemia. Based on the glucose reading, appropriate interventions can be initiated, such as administering dextrose, glucagon, or oral sugars like orange juice if hypoglycemia is confirmed. However, verifying the blood glucose level is the initial step to guide subsequent actions and ensure patient safety.

2. A client who is postoperative is verbalizing pain as a 2 on a pain scale of 0 to 10. Which of the following statements should the nurse identify as an indication that the client understands the preoperative teaching they received about pain management?

• A. ''I think I should take my pain medication more often, since it is not controlling my pain.''
• B. ''Breathing faster will help me keep my mind off of the pain.''
• C. ''It might help me to listen to music while I'm lying in bed.''
• D. ''I don't want to walk today because I have some pain.''

Correct answer: D

Rationale: The correct answer is D because the client is demonstrating an understanding of the preoperative teaching by acknowledging the pain and relating it to the need to rest. Walking may exacerbate the pain, and the client's decision not to walk shows an awareness of their body's signals. Choices A, B, and C are incorrect as they do not reflect a good understanding of pain management. Choice A suggests self-medicating without consulting healthcare providers, choice B focuses on distraction rather than addressing the pain, and choice C offers a coping mechanism but does not address the pain directly.

3. Which of the following best defines the role of a nurse educator?

• A. Provide direct patient care
• B. Conduct research on nursing practices
• C. Develop and implement educational programs for nursing staff
• D. Supervise nursing staff

Correct answer: C

Rationale: The role of a nurse educator primarily involves developing and implementing educational programs for nursing staff. While providing direct patient care and supervising nursing staff are essential functions in healthcare, these tasks are not the primary responsibilities of a nurse educator. Conducting research on nursing practices is typically associated with the role of a nurse researcher, not a nurse educator.

4. There are several pitfalls that should be avoided when using social media of any type. For example, a nurse or student could be found guilty of libel in which of the following scenarios?

• A. Snapping a selfie with a patient
• B. Posting a positive review of the hospital where the student completed clinicals
• C. Creating a closed online forum where students can discuss clinical experiences without providing client information
• D. Complaining about her nurse preceptor on social media, discussing the preceptor’s unprofessional characteristics.

Correct answer: D

Rationale: Complaining about her nurse preceptor on social media, discussing the preceptor’s unprofessional characteristics, could be considered libel.

5. Which statement by the patient indicates a need for additional instruction in administering insulin?

• A. 'I need to rotate injection sites among my arms, legs, and abdomen each day.'
• B. 'I can buy the 0.5 mL syringes because the line markings will be easier to see.'
• C. 'I should draw up the regular insulin first after injecting air into the NPH bottle.'
• D. 'I do not need to aspirate the plunger to check for blood before injecting insulin.'

Correct answer: A

Rationale: This statement indicates a need for additional instruction because while site rotation is essential, it's important to rotate sites within the same anatomical region (such as staying within the abdomen for several injections before moving to a different region). Rotating too frequently between different regions can cause inconsistent insulin absorption, which can affect blood sugar control.

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