Nursing Elites

1. Steven John has type 1 diabetes mellitus and receives insulin. Which laboratory test will the nurse assess?

• A. Potassium
• B. AST (aspartate aminotransferase)
• C. Serum amylase
• D. Sodium

Correct answer: A

Rationale: The correct answer is A: Potassium. Patients with type 1 diabetes receiving insulin are at risk of developing hypokalemia due to insulin's effects on potassium levels. Monitoring potassium levels is crucial to prevent complications such as cardiac arrhythmias. Choices B, C, and D are incorrect because AST, serum amylase, and sodium levels are not directly impacted by insulin therapy in type 1 diabetes and are not the primary concern that needs monitoring in this scenario.

2. A nurse is providing discharge teaching to the parent of a toddler who has a new diagnosis of asthma. The parent states she is unable to afford the nebulizer prescribed for the child. Which of the following referrals should the nurse recommend?

• A. Social worker
• B. Pharmacist
• C. Respiratory therapist
• D. Child protective services

Correct answer: A

Rationale: The correct answer is A: Social worker. A social worker can assist the parent in finding resources to afford the nebulizer. While a pharmacist may provide information about medications and devices, they may not have direct resources to address financial concerns. A respiratory therapist focuses on respiratory care but may not specialize in financial assistance. Referring to child protective services is not appropriate in this scenario as the parent's inability to afford a nebulizer does not indicate neglect or abuse.

3. Which of the following is considered an internal disaster?

• A. A patient fall
• B. The massive spread of pneumonia
• C. A computer hacking episode
• D. Unexpected staff absences due to illness

Correct answer: C

Rationale: A computer hacking episode is considered an internal disaster as it disrupts the internal operations of the healthcare facility, compromising data security and potentially impacting patient care. Choices A, B, and D do not directly relate to internal disasters in a healthcare setting. A patient fall is a patient safety issue, the massive spread of pneumonia is a public health concern, and unexpected staff absences due to illness may affect staffing levels but are not typically classified as internal disasters.

4. Insulin forces which of the following electrolytes out of the plasma and into the cells?

• A. Calcium
• B. Magnesium
• C. Phosphorus
• D. Potassium

Correct answer: D

Rationale: Insulin forces potassium out of the plasma and into the cells, which can cause hypokalemia. This is because insulin enhances the activity of the sodium-potassium pump in cell membranes, promoting the movement of potassium from the extracellular fluid into the cells. Choices A, B, and C are incorrect as insulin does not directly influence the movement of calcium, magnesium, or phosphorus in the same manner as it does with potassium.

5. A charge nurse on an obstetrical unit is preparing the shift assignment. Which of the following clients should be assigned to an RN who has floated from a medical-surgical unit?

• A. A client who is at 32 weeks of gestation and has premature rupture of membranes
• B. A multigravida client who has preeclampsia and is receiving misoprostol for induction of labor
• C. A primigravida client who is 1 day postoperative following a Cesarean section and has a PCA pump
• D. A client who has gestational diabetes and is receiving biweekly nonstress tests

Correct answer: C

Rationale: A nurse who floated from a medical-surgical unit would be appropriate to care for a client who is 1 day postoperative following a Cesarean section and has a PCA pump. This client requires monitoring of the postoperative incision site, pain management through the PCA pump, and assessment for any signs of complications related to the surgery. Assigning this client to an RN with experience in postoperative care aligns with providing specialized and appropriate care. Choices A, B, and D involve conditions or procedures specific to obstetrics that would be better managed by a nurse with obstetrical experience, making them incorrect choices for the floated RN.

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