Nursing Elites

1. Nurse Wayne is aware that a positive Chvostek's sign indicates:

• A. Hypocalcemia
• B. Hyponatremia
• C. Hypokalemia
• D. Hypermagnesemia

Correct answer: A

Rationale: A positive Chvostek's sign indicates hypocalcemia. This sign is elicited by tapping the facial nerve anterior to the ear, resulting in facial muscle twitching due to increased neuromuscular irritability from low calcium levels. Hyponatremia (Choice B) is characterized by low sodium levels, but it does not present with Chvostek's sign. Hypokalemia (Choice C) is low potassium levels, and hypermagnesemia (Choice D) is high magnesium levels, neither of which are associated with Chvostek's sign.

2. The patient expects that a type 1 diabetic may receive ____ of their morning dose of insulin preoperatively:

• A. 10-20%.
• B. 25-40%.
• C. 50-60%.
• D. 85-90%.

Correct answer: B

Rationale: It is common practice to administer 25-40% of the morning dose of insulin preoperatively to prevent hypoglycemia during surgery. Giving a lower percentage (A) may not provide sufficient glycemic control, while higher percentages (C, D) can increase the risk of hypoglycemia during the surgical procedure.

3. The client with type 2 DM is being taught about the importance of foot care. Which instruction should be included?

• A. Soak your feet in hot water every night.
• B. Walk barefoot whenever possible.
• C. Use a heating pad to warm your feet.
• D. Wear comfortable shoes that allow air circulation.

Correct answer: D

Rationale: The correct instruction for the client with type 2 DM regarding foot care is to wear comfortable shoes that allow air circulation. This helps prevent foot injuries and infections, which are common complications in clients with diabetes. Choice A is incorrect as soaking feet in hot water can lead to burns and skin damage. Choice B is incorrect because walking barefoot increases the risk of injury and infection. Choice C is incorrect as using a heating pad can also potentially lead to burns and skin damage.

4. A client with DM is taking regular and NPH insulin every morning. The nurse should provide which instruction to the client?

• A. Take the regular insulin first, then the NPH insulin.
• B. Take the NPH insulin first, then the regular insulin.
• C. Mix the insulins in a separate syringe.
• D. Take the regular insulin first and immediately follow it with the NPH insulin.

Correct answer: A

Rationale: The correct instruction for the client is to take the regular insulin first, then the NPH insulin. Regular insulin should be administered before NPH insulin to prevent contamination and maintain the potency of each insulin type. Choice B is incorrect because NPH insulin should not be taken before regular insulin. Mixing the insulins in a separate syringe, as suggested in choice C, is not recommended as it may alter the effectiveness of the insulins. Choice D is also incorrect as taking the regular insulin first and immediately following it with NPH insulin is not the recommended administration sequence.

5. When should a new nurse graduate consider applying for a position as a nurse manager?

• A. When she is comfortable in her current position
• B. When she begins mentoring other new nurses
• C. As soon as a position opens
• D. When she has developed leadership and clinical expertise

Correct answer: D

Rationale: A new nurse graduate should consider applying for a position as a nurse manager when she has developed leadership and clinical expertise. Option A, 'When she is comfortable in her current position,' is incorrect as comfort in the current position may not necessarily align with the skills required for a managerial role. Option B, 'When she begins mentoring other new nurses,' is not a definitive indicator of readiness for a managerial position. Option C, 'As soon as a position opens,' does not take into account the necessary skills and experience required for a nurse manager role. Therefore, the best time to consider applying for a nurse manager position is after developing the required leadership and clinical expertise.

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