Nursing Elites

1. Becky is a 17-year-old type I diabetic who has been admitted for her third episode of diabetic ketoacidosis (DKA) since being diagnosed last year. She states that she hates feeling different from her friends and refuses to take her insulin as recommended. What would be the most helpful action for Becky?

• A. Scolding her for not taking her insulin
• B. Recommending that she use an insulin pump
• C. Contacting the local support group for diabetic teens
• D. Telling her parents they must provide more strict oversight

Correct answer: C

Rationale: Contacting the local support group for diabetic teens would be the most helpful action for Becky. By reaching out to see if another diabetic teenager could provide support, Becky would have the opportunity to connect with someone in her peer group who faces similar challenges. This connection can help reduce her sense of isolation and the feeling of being 'different.' Choice A, 'Scolding her for not taking her insulin,' is inappropriate and could further alienate Becky. It does not address the underlying emotional issues driving her behavior. Choice B, 'Recommending that she use an insulin pump,' does not directly address Becky's emotional struggle with feeling different from her friends. While an insulin pump may be a helpful tool, it does not tackle the root cause of her non-compliance. Choice D, 'Telling her parents they must provide more strict oversight,' focuses on imposing stricter control without addressing Becky's emotional needs or offering peer support, which may not be effective in improving her insulin adherence in the long term.

2. Which behavior observed by the nurse indicates a suspicion that a depressed adolescent client may be suicidal?

• A. The adolescent gives away a DVD player and a cherished autographed picture of a performer.
• B. The adolescent runs out of group therapy, swearing at the group leader, and then goes to her room.
• C. The adolescent becomes angry while speaking on the phone and slams down the receiver.
• D. The adolescent gets angry with her roommate when the roommate borrows her clothes without asking.

Correct answer: A

Rationale: The correct answer is when the adolescent gives away a DVD player and a cherished autographed picture of a performer. This behavior is concerning because a depressed suicidal client often gives away things of value as a way of saying goodbye and wanting to be remembered. Choices B, C, and D all involve anger and acting-out behaviors, which are common in adolescents but do not specifically indicate suicidal ideation. Running out of group therapy, swearing, and going to her room, becoming angry and slamming the phone receiver, or getting upset when her roommate borrows her clothes are not clear indications of suicidal thoughts.

3. As a nursing supervisor in a long-term care facility, you prioritize strict infection control prevention measures due to the understanding that the normal aging process weakens the body's defenses. Which theory of aging supports the necessity of strict infection control prevention measures?

• A. The Programmed Longevity Theory
• B. The Immunological Theory of Aging
• C. The Endocrine Theory
• D. The Rate of Living Theory

Correct answer: B

Rationale: The theory of aging that aligns with the need for strict infection control prevention measures is the Immunological Theory of Aging. This theory posits that aging leads to a decline in the body's immune defenses and a reduced ability of antibodies to protect against infections. The other theories do not directly address the impact of aging on the immune system. The Programmed Longevity Theory focuses on genetic changes affecting aging, the Endocrine Theory emphasizes hormonal changes, and the Rate of Living Theory relates longevity to the rate of oxygen metabolism.

4. A client is receiving education on cholesterol. Which of the following statements from the client indicates the need for further teaching?

• A. I would like my HDL levels to be over 50.
• B. It is better for me to have high HDL levels and low LDL levels.
• C. It is better for me to have high LDL levels and low HDL levels.
• D. My goal is to get my total cholesterol below 200.

Correct answer: C

Rationale: The correct answer is, 'It is better for me to have high LDL levels and low HDL levels.' This statement indicates a need for further teaching because high LDL levels contribute to atherosclerosis, while high HDL levels can protect against heart disease. The client should understand the importance of lowering LDL levels and increasing HDL levels to maintain good heart health. Choice A is correct as desiring HDL levels over 50 is a positive goal. Choice B is correct as it reflects the ideal scenario of high HDL and low LDL levels. Choice D is correct as a total cholesterol below 200 is a common goal for heart health. Therefore, Choice C is incorrect as it suggests an opposite and unhealthy relationship between LDL and HDL levels.

5. Because of budget cuts in the hospital, the nursing manager informs the staff that they must either rotate to other units more often or take their turns staying home from work. Which principle is this nurse manager demonstrating?

• A. Justice
• B. Paternalism
• C. Veracity
• D. Fraternity

Correct answer: D

Rationale: Veracity involves truth-telling, even in challenging situations. In this scenario, the nurse manager is being transparent about the need for staff to rotate units or take turns staying home due to budget cuts. This allows the staff to make informed decisions about their work schedules and potential impact on their pay and work areas. Option A, Justice, does not apply as the focus is on communication and transparency, not fairness. Option B, Paternalism, does not fit as it involves decisions made for others' well-being without their input, which is not the case here. Option D, Fraternity, pertains to unity among individuals, which is not the principle demonstrated by the nurse manager in this situation.

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