Nursing Elites

1. Discharge plans of diabetic clients include injection site rotation. You should emphasize that the space between sites should be:

• A. 6.0 cm.
• B. 5.0 cm.
• C. 2.5 cm.
• D. 4.0 cm.

Correct answer: A

Rationale: Patient safety and efficacy of care depend on actions rooted in established nursing protocols that consider both the immediate and long-term needs of the patient.

2. All of the following are instructions for proper foot care to be given to a client with peripheral vascular disease caused by diabetes. Which one is not?

• A. Trim nails using a nail clipper
• B. Apply cornstarch to the foot
• C. Always check the temperature of the water before bathing
• D. Use canvas shoes

Correct answer: A

Rationale: The correct answer is 'A', which says trim nails using a nail clipper. This is incorrect because patients with peripheral vascular disease, particularly those caused by diabetes, should not trim their nails themselves due to the risk of injury, infection, and poor wound healing. The other options, 'B', 'C', and 'D', are correct advice for diabetic foot care. Applying cornstarch can help keep the feet dry and prevent fungal infections. Checking the water temperature before bathing can prevent burns, as patients with peripheral vascular disease often have decreased sensation in their feet. Wearing canvas shoes can improve foot ventilation and reduce the risk of foot ulcers and infections.

3. A condition that often progresses to become type 2 diabetes mellitus is:

• A. type 1 diabetes mellitus
• B. high blood pressure
• C. chronic pancreatitis
• D. impaired glucose tolerance

Correct answer: D

Rationale: Impaired glucose tolerance is a pre-diabetic state characterized by higher than normal blood sugar levels. It is often associated with insulin resistance and can progress to type 2 diabetes mellitus. Type 1 diabetes mellitus (Choice A) is an autoimmune condition where the body attacks insulin-producing cells, leading to a lack of insulin production. High blood pressure (Choice B) and chronic pancreatitis (Choice C) are not directly linked to the progression to type 2 diabetes mellitus.

4. Which of the following is a normal finding during assessment of a Chest tube in a 3 way bottle system?

• A. There is a continuous bubbling in the drainage bottle
• B. There is an intermittent bubbling in the suction control bottle
• C. The water fluctuates during inhalation of the patient
• D. There is 3 cm of water left in the water seal bottle

Correct answer: C

Rationale: Effective nursing care involves comprehensive assessments that address all aspects of a patient's condition, ensuring that interventions are appropriately targeted and outcomes are optimized.

5. What is a major feature of the therapeutic lifestyle changes (TLC) recommended for the treatment of high blood cholesterol?

• A. Avoiding all foods that contain cholesterol
• B. Reducing sodium intake to less than 2 g/day
• C. Limiting total fat intake to less than 30% of energy intake
• D. Limiting saturated fat intake to less than 7% of energy intake

Correct answer: D

Rationale: The correct answer is D, 'Limiting saturated fat intake to less than 7% of energy intake.' This is a central feature of the therapeutic lifestyle changes (TLC) recommended for treating high blood cholesterol. Saturated fats can increase low-density lipoprotein (LDL) cholesterol, a significant risk factor for heart disease. Choice A is incorrect because while it is recommended to limit cholesterol intake, it's not suggested to avoid all foods containing cholesterol entirely in the TLC. Choice B is also incorrect as although reducing sodium intake is beneficial for controlling blood pressure, it's not specifically targeted in the TLC for managing high cholesterol. Lastly, while limiting total fat intake is a healthy guideline, it's not as specific or effective as limiting saturated fat intake, making choice C also incorrect.

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