Nursing Elites

1. Nurse Perry is caring for a female client with type 1 diabetes mellitus who exhibits confusion, light-headedness, and aberrant behavior. The client is still conscious. The nurse should first administer:

• A. I.M. or subcutaneous glucagon.
• B. I.V. bolus of dextrose 50%.
• C. 15 to 20 g of a fast-acting carbohydrate such as orange juice.
• D. 10 U of fast-acting insulin.

Correct answer: C

Rationale: For a conscious client with hypoglycemia, the initial treatment should involve administering 15 to 20 g of a fast-acting carbohydrate, such as orange juice. This helps rapidly raise the client's blood glucose levels. Choices A and D are incorrect as administering glucagon or fast-acting insulin is not the first-line treatment for hypoglycemia in a conscious client. Choice B, an I.V. bolus of dextrose 50%, is a more invasive and aggressive intervention that is not typically indicated for a conscious client with hypoglycemia.

2. The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following interventions should the nurse implement?

• A. Encourage increased fluid intake
• B. Administer vasopressin
• C. Monitor for signs of dehydration
• D. Restrict oral fluids

Correct answer: D

Rationale: The correct intervention for a client with syndrome of inappropriate antidiuretic hormone (SIADH) is to restrict oral fluids. SIADH leads to excessive release of antidiuretic hormone (ADH), causing the body to retain water and diluting the sodium levels in the blood (hyponatremia). Restricting oral fluids helps prevent further water retention and worsening hyponatremia. Encouraging increased fluid intake (choice A) would exacerbate the problem by further diluting sodium levels. Administering vasopressin (choice B) is not indicated in SIADH, as the condition is characterized by excess ADH secretion. Monitoring for signs of dehydration (choice C) is not the priority in SIADH since the issue is water retention rather than dehydration.

3. A nurse manager conducts evaluations with each staff member and reviews the staffing needs for the upcoming year. Which of the following best describes the behavior this manager is engaging in?

• A. Interpersonal activities
• B. Decisional activities
• C. Informational activities
• D. Transformational activities

Correct answer: B

Rationale: The correct answer is B: Decisional activities. A nurse manager conducting evaluations and reviewing staffing needs for the future involves making decisions related to resource allocation, planning, and problem-solving. These activities fall under the category of decisional activities in management. Choice A, Interpersonal activities, would involve activities like communicating, motivating, and leading staff. Choice C, Informational activities, would involve activities like gathering and disseminating information. Choice D, Transformational activities, would involve inspiring and motivating staff to achieve organizational goals through vision and change.

4. The client with DM is being instructed by the nurse about the importance of controlling blood glucose levels. The nurse should emphasize that uncontrolled blood glucose can lead to:

• A. Increased risk of heart disease and stroke.
• B. Improved wound healing.
• C. Reduced need for medication.
• D. Decreased risk of infection.

Correct answer: A

Rationale: The correct answer is A: Increased risk of heart disease and stroke. Uncontrolled blood glucose levels in clients with diabetes mellitus (DM) can lead to cardiovascular complications, such as heart disease and stroke. High blood glucose levels can damage blood vessels over time, increasing the risk of atherosclerosis and cardiovascular events. Choices B, C, and D are incorrect because uncontrolled blood glucose levels do not improve wound healing, reduce the need for medication, or decrease the risk of infection. In fact, uncontrolled blood glucose levels can impair wound healing, require more medications to manage symptoms, and increase the risk of infections due to compromised immune function.

5. Which of the following is an example of nonmaleficence in nursing practice?

• A. Administering pain medication as prescribed to prevent patient discomfort.
• B. Ensuring that a patient does not receive a treatment that they have refused.
• C. Ensuring that a patient receives appropriate care without causing harm.
• D. Encouraging a patient to express their concerns and fears about a procedure.

Correct answer: B

Rationale: Nonmaleficence is the ethical principle of doing no harm. In nursing practice, ensuring that a patient does not receive a treatment they have refused is an example of nonmaleficence. Choice A focuses on beneficence by providing pain relief. Choice C is more aligned with beneficence as it emphasizes providing appropriate care without harm. Choice D pertains to patient communication but does not directly address the concept of nonmaleficence.

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