Nursing Elites

1. In which of the following situations would the EMT MOST likely deliver a baby at the scene?

• A. A tornado has struck and blocked the only route to the hospital.
• B. Contractions are 8 to 10 minutes apart and irregular.
• C. The amniotic sac has ruptured, and contractions occur regularly.
• D. The hospital is 15 miles away, and crowning is not present.

Correct answer: A

Rationale: The EMT may be required to deliver a baby at the scene when external factors like a tornado have blocked the only route to the hospital, making it impossible to reach the medical facility in time for delivery. In such emergencies, the EMT must be prepared to manage the childbirth process until further medical assistance can be obtained.

2. A child newly diagnosed with diabetes mellitus has been stabilized with insulin injections daily. A nurse prepares a discharge teaching plan regarding the insulin. The teaching plan should reinforce which of the following concepts?

• A. Always store insulin vials in the refrigerator
• B. Adjust insulin dosage before exercise
• C. Presence of ketones in urine indicates a need for less insulin
• D. Systematically rotate injection sites

Correct answer: D

Rationale: Systematically rotating injection sites is crucial to prevent tissue damage and ensure optimal insulin absorption. This practice helps in preventing lipohypertrophy, a condition characterized by fat accumulation at injection sites, which can affect insulin absorption and lead to inconsistent blood glucose control. By rotating injection sites, the risk of skin and tissue damage is minimized, and insulin's effectiveness is maintained over time.

3. Kobby, who is diagnosed with diabetes mellitus type 1, displays symptoms of hypoglycemia; which of the following actions should the nurse instruct the parents to take?

• A. Give the child honey (simple sugar)
• B. Give the child milk (complex sugar)
• C. Contact the healthcare provider before doing anything
• D. Give the child nothing by mouth

Correct answer: A

Rationale: During hypoglycemia, it is crucial to quickly raise blood glucose levels. Giving a simple sugar like honey is recommended as it can rapidly increase blood sugar levels and alleviate the symptoms of hypoglycemia in individuals with diabetes mellitus type 1. Milk, being a complex sugar, will not act as quickly as honey in raising blood sugar levels. Contacting the healthcare provider may lead to a delay in treatment, as immediate action is necessary during hypoglycemia. Withholding food or drink (choice D) is not appropriate when dealing with hypoglycemia as it can worsen the condition.

4. What is the leading cause of death in geriatric patients?

• A. Hypertension.
• B. Arthritis.
• C. Heart disease.
• D. Altered mental status.

Correct answer: C

Rationale: Heart disease is the leading cause of death in geriatric patients. It encompasses a range of conditions affecting the heart and blood vessels, such as coronary artery disease and heart failure, which are more prevalent in older individuals. These conditions can lead to serious complications and ultimately result in higher mortality rates among the elderly population. Hypertension (choice A) is a risk factor for heart disease but not the leading cause of death in geriatric patients. Arthritis (choice B) is a chronic condition affecting the joints, not a primary cause of death in this population. Altered mental status (choice D) is a symptom rather than a leading cause of death in geriatric patients.

5. Which intervention is not appropriate for the hospitalized adolescent?

• A. Allowing the adolescent to assist with procedures when possible.
• B. Encouraging them to discuss their thoughts and feelings about the hospitalization.
• C. Encouraging them to remain in the room throughout the hospitalization to ensure adequate rest periods.
• D. Encouraging peer visitation.

Correct answer: C

Rationale: Encouraging the adolescent to remain in the room throughout the hospitalization to ensure adequate rest periods is not appropriate. It is crucial for adolescents to have opportunities for physical activity and social interaction to promote their well-being during hospitalization. Allowing them to assist with procedures when possible can empower them and provide a sense of control. Encouraging discussions about their thoughts and feelings helps address their emotional needs. Facilitating peer visitation fosters social support, which is beneficial for their well-being. Therefore, choice C is the least appropriate as it restricts important aspects of the adolescent's development and coping mechanisms during hospitalization.

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