Nursing Elites

1. The best indicator that the client has learned how to give an insulin self-injection correctly is when the client can:

• A. Perform the procedure safely and correctly.
• B. Critique the nurse's performance of the procedure.
• C. Explain all steps of the procedure correctly.
• D. Correctly answer a posttest about the procedure.

Correct answer: A

Rationale: The correct answer is A. Learning is best demonstrated by a change in behavior. A client who can safely and correctly perform the procedure shows they have acquired the skill. Choice B is incorrect because critiquing the nurse's performance does not directly demonstrate the client's ability to perform the procedure. Choice C is incorrect because explaining the steps does not guarantee the client can physically perform the injection. Choice D is incorrect as answering a posttest only assesses theoretical knowledge, not practical application.

2. During an interview with a client planning elective surgery, the client asks the nurse, 'What is the advantage of having a preferred provider organization insurance plan?' Which response is best for the nurse to provide?

• A. Neither plan allows the selection of healthcare providers or hospitals.
• B. There are fewer healthcare providers to choose from than in an HMO plan.
• C. An individual may select healthcare providers from outside of the PPO network.
• D. An individual can become a member of a PPO without belonging to a group.

Correct answer: C

Rationale: The best response for the nurse to provide is option C, as it highlights a key advantage of a preferred provider organization (PPO) insurance plan. By stating that an individual may select healthcare providers from outside of the PPO network, the nurse emphasizes the flexibility and freedom of choice that PPO plans offer. This feature allows individuals to seek care from providers who are not part of the PPO network, albeit at a higher cost. Option A is incorrect because both PPO and HMO plans allow the selection of healthcare providers, although with different restrictions. Option B is incorrect as PPO plans typically offer a larger selection of healthcare providers compared to HMO plans. Option D is incorrect as membership in a PPO usually requires affiliation with a group, such as through employment or membership in an organization.

3. The client had a thyroidectomy 24 hours ago and reports experiencing numbness and tingling of the face. Which intervention should the nurse implement?

• A. Open and prepare the tracheostomy kit.
• B. Inspect the neck for an increase in swelling.
• C. Monitor for the presence of Chvostek's sign.
• D. Assess lung sounds for laryngeal stridor.

Correct answer: C

Rationale: The correct answer is C: Monitor for the presence of Chvostek's sign. Chvostek's sign is a clinical indicator of hypocalcemia, a common complication after thyroidectomy. Numbness and tingling around the face are associated with hypocalcemia due to potential damage to the parathyroid glands during surgery, leading to decreased calcium levels. Inspecting the neck for swelling (choice B) is important but does not directly address the presenting symptoms. Opening and preparing the tracheostomy kit (choice A) is not necessary based on the client's current symptoms. Assessing lung sounds for laryngeal stridor (choice D) is not directly related to the client's reported numbness and tingling of the face.

4. A client with renal calculi is being assessed by a nurse. Which question should the nurse ask?

• A. Is there a family history of this problem?
• B. Do you consume cranberry juice?
• C. Do you urinate after sexual intercourse?
• D. Do you have burning sensation during urination?

Correct answer: A

Rationale: When assessing a client with renal calculi, it is important for the nurse to inquire about a family history of the problem. There is a genetic predisposition associated with renal stone formation, making it essential to assess if other family members have experienced renal stones. Choices B, C, and D are not directly related to renal calculi. Consuming cranberry juice is more relevant to urinary tract health, urinating after sexual intercourse is related to preventing urinary tract infections, and experiencing a burning sensation during urination is a symptom commonly associated with urinary tract infections, not renal calculi.

5. Which clients are at risk for kidney problems? (Select all that apply.)

• A. Clients taking synthetic creatine supplements
• B. Clients taking metformin for diabetes mellitus
• C. Clients taking high-dose nonsteroidal anti-inflammatory drugs (NSAIDs) for chronic back pain
• D. Clients taking prenatal vitamins and using albuterol nebulizers

Correct answer: A

Rationale: Clients who take synthetic creatine supplements, metformin, and high-dose or long-term NSAIDs are at risk for kidney dysfunction. Synthetic creatine supplements can cause kidney damage, metformin may rarely cause lactic acidosis leading to renal impairment, and high-dose NSAIDs can lead to acute kidney injury. Prenatal vitamins and albuterol nebulizers are not known to significantly impact kidney function, thus do not pose a risk for kidney problems.

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