Nursing Elites

1. Dr. Kennedy prescribes glipizide (Glucotrol), an oral antidiabetic agent, for a male client with type 2 diabetes mellitus who has been having trouble controlling the blood glucose level through diet and exercise. Which medication instruction should the nurse provide?

• A. Be sure to take glipizide 30 minutes before meals.
• B. Glipizide may cause a low serum sodium level, so make sure you have your sodium level checked monthly.
• C. You won't need to check your blood glucose level after you start taking glipizide.
• D. Take glipizide after a meal to prevent heartburn.

Correct answer: A

Rationale: Glipizide should be taken 30 minutes before meals to maximize its glucose-lowering effect.

2. What is the nurse's responsibility when dealing with an impaired colleague?

• A. The nurse should report the colleague to a supervisor and follow the institution's policy for addressing impaired practice.
• B. The nurse should confront the colleague directly and offer support to seek help for the impairment.
• C. Nonmaleficence
• D. The nurse should ignore the colleague's behavior and focus on their own responsibilities.

Correct answer: A

Rationale: When a nurse encounters an impaired colleague, the appropriate action is to report the behavior to a supervisor and follow the institution's policy for addressing impaired practice. This ensures patient safety and upholds professional standards. Choice B is incorrect because confronting the colleague directly may not be appropriate or effective in addressing the issue, and the colleague may need more structured assistance. Choice C is a principle of ethical practice but does not directly address the specific situation of dealing with an impaired colleague. Choice D is incorrect because ignoring the colleague's behavior could potentially compromise patient safety and is not in line with professional responsibility.

3. The healthcare provider is providing dietary instructions to a client with hyperthyroidism. Which of the following foods should the client avoid?

• A. Seafood
• B. Spinach
• C. Bananas
• D. Oatmeal

Correct answer: A

Rationale: The client with hyperthyroidism should avoid foods high in iodine, as it can exacerbate the condition by increasing thyroid hormone production. Seafood, particularly ocean fish, is rich in iodine, making it a food to avoid. Spinach, bananas, and oatmeal do not contain high levels of iodine and are generally safe for individuals with hyperthyroidism.

4. Which of the following is an interpersonal activity of nurse managers, but not necessarily all nurse leaders?

• A. Coaching
• B. Resource allocation
• C. Planning for the future
• D. Monitoring

Correct answer: A

Rationale: The correct answer is A: Coaching. Nurse managers are directly involved in coaching their team members, providing guidance, support, and mentorship. This is a key interpersonal activity that focuses on developing the skills and performance of individual team members. While nurse leaders may also engage in coaching activities, it is a more specific and hands-on role for nurse managers. Choice B, resource allocation, is a managerial function that involves distributing resources effectively and efficiently. Choice C, planning for the future, is a strategic activity that involves setting goals and directions for the organization. Choice D, monitoring, is a supervisory task that involves overseeing and evaluating processes and outcomes. These activities are important for nurse leaders as well as nurse managers, but coaching is a more direct interpersonal interaction typically associated with nurse managers.

5. The client with DM is being taught by the nurse about the importance of monitoring blood glucose levels. The nurse should instruct the client to:

• A. Check blood glucose only when feeling unwell.
• B. Check blood glucose before meals and at bedtime.
• C. Check blood glucose only after meals.
• D. Check blood glucose only in the morning.

Correct answer: B

Rationale: The correct answer is to check blood glucose before meals and at bedtime. Monitoring blood glucose levels before meals allows the client to adjust their insulin or oral antidiabetic medications based on their current levels. Checking at bedtime helps in ensuring blood glucose levels are at a safe range throughout the night. Option A is incorrect because blood glucose should be monitored regularly as part of diabetes management, not just when feeling unwell. Option C is incorrect because checking only after meals does not provide a complete picture of blood glucose control throughout the day. Option D is incorrect as checking only in the morning does not cover the full spectrum of blood glucose variations that can occur during the day.

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