Nursing Elites

1. Major complications of diabetes include damage to the:

• A. stomach, liver, and pancreas
• B. eyes, nerves, and kidneys
• C. skin, blood vessels, and lungs
• D. brain, pituitary gland, and thyroid gland

Correct answer: B

Rationale: The correct answer is B: eyes, nerves, and kidneys. In diabetes, major complications result from damage to small blood vessels that supply these organs. Damage to the eyes can lead to retinopathy, to the nerves causing neuropathy, and to the kidneys causing nephropathy. Choices A, C, and D are incorrect as they do not represent the typical major complications associated with diabetes.

2. In monitoring the patient in PACU, the nurse correctly identifies that checking the patient's vital signs is done every:

• A. 1 hour
• B. 5 minutes
• C. 15 minutes
• D. 30 minutes

Correct answer: A

Rationale: Correct Answer: A - Vital signs monitoring in the PACU (Post-Anesthesia Care Unit) is typically done every hour to closely monitor the patient's condition during the immediate postoperative period. This frequency allows the nurse to promptly identify any changes in the patient's vital signs and intervene as necessary. Choice B (5 minutes) is too frequent for routine vital signs monitoring in the PACU and may not allow for a comprehensive assessment of the patient's stability. Choice C (15 minutes) and Choice D (30 minutes) are also not in line with the standard practice of vital signs monitoring in the PACU, which is typically hourly.

3. Which nursing diagnosis is a priority for clients with Borderline personality disorder?

• A. Risk for injury
• B. Ineffective individual coping
• C. Altered thought process
• D. Sensory perceptual alteration

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.

4. In some hip surgeries, an epidural catheter for Fentanyl epidural analgesia is given. What is your nursing priority care in such a case?

• A. Instruct the client to observe strict bed rest
• B. Check for epidural catheter drainage
• C. Administer analgesia through the epidural catheter as prescribed
• D. Assess respiratory rate carefully

Correct answer: D

Rationale: The nursing priority care in a case where an epidural catheter for Fentanyl epidural analgesia is given during hip surgeries is to assess the respiratory rate carefully. Respiratory depression is a potential side effect of Fentanyl, especially when administered epidurally. Monitoring the respiratory rate is crucial to detect any signs of respiratory distress promptly. Instructing the client to observe strict bed rest (Choice A) may be necessary but is not the priority over ensuring respiratory function. Checking for epidural catheter drainage (Choice B) and administering analgesia through the epidural catheter as prescribed (Choice C) are important aspects of care, but ensuring adequate ventilation takes precedence to prevent complications.

5. Intrinsic factor from the stomach is needed for the absorption of which vitamin?

• A. vitamin B12
• B. folate
• C. niacin
• D. vitamin B6

Correct answer: A

Rationale: The correct answer is A: vitamin B12. Intrinsic factor is a glycoprotein produced by the stomach that is necessary for the absorption of vitamin B12 in the small intestine. Vitamin B12 binds to intrinsic factor in the stomach, forming a complex that is then absorbed in the ileum. This absorption process is crucial for preventing vitamin B12 deficiency. Choices B, C, and D are incorrect because they do not require intrinsic factor for absorption. Folate is absorbed in the small intestine through a different mechanism, niacin can be absorbed in the small intestine without the need for intrinsic factor, and vitamin B6 does not rely on intrinsic factor for absorption.

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