Nursing Elites

1. What is the best nursing diagnosis for a client with newly diagnosed Diabetes Mellitus?

• A. Impaired Skin Integrity
• B. Knowledge Deficit: New Diabetes Diagnosis
• C. Alteration in Nutrition: More than Body Requirements
• D. Fluid Volume Deficit

Correct answer: B

Rationale: The correct answer is 'Knowledge Deficit: New Diabetes Diagnosis.' Newly diagnosed diabetics require education on their disease, medications, glucose testing, insulin injections, foot care, and sick-day plans. Choices A and D aim to prevent issues that do not currently exist for the client. Choice C, 'Alteration in Nutrition: More than Body Requirements,' is not the priority diagnosis for a newly diagnosed diabetic. While nutritional adjustments may be required for type I or type II diabetes, providing knowledge and education takes precedence at this stage.

2. The client is preparing to learn about the effects of isoniazid (INH). Which information is essential for the client to understand?

• A. Isoniazid should be taken with meals to reduce gastrointestinal upset.
• B. Prolonged use of isoniazid may result in dark, concentrated urine.
• C. Taking aluminum hydroxide (Maalox) with isoniazid can enhance the drug's effects.
• D. Consuming alcohol daily can increase the risk of drug-induced hepatitis.

Correct answer: D

Rationale: It is crucial for the client to understand that consuming alcohol while on isoniazid can increase the risk of drug-induced hepatitis. Hepatic damage can lead to dark, concentrated urine. To minimize gastrointestinal upset, it is recommended to take isoniazid with meals rather than on an empty stomach. Additionally, the client should avoid taking aluminum-containing antacids like aluminum hydroxide with isoniazid, as it can reduce the drug's effectiveness. Choice A is incorrect because isoniazid should not be taken on an empty stomach to help reduce GI upset. Choice B is incorrect, as prolonged use of isoniazid does not typically cause dark, concentrated urine. Choice C is incorrect as taking aluminum hydroxide with isoniazid does not enhance the drug's effects; in fact, it may decrease its effectiveness.

3. The factor that most determines drug distribution is:

• A. vascular perfusion of the tissue or organ.
• B. salt form.
• C. drug interactions.
• D. steady state.

Correct answer: A

Rationale: The correct answer is 'vascular perfusion of the tissue or organ.' Drug distribution is primarily determined by how well the circulatory system delivers the drug to various tissues and organs. Adequate perfusion ensures proper distribution of the drug throughout the body. While the salt form (choice B), drug interactions (choice C), and steady state (choice D) can influence drug efficacy and metabolism, they are not as crucial as vascular perfusion for the initial distribution of a drug.

4. A patient has recently been prescribed Norvasc. Which of the following side effects should the patient specifically watch out for?

• A. Hypotension and Angina
• B. Hypertension
• C. Lower extremity edema
• D. Peripheral sensory loss and SOB

Correct answer: A

Rationale: The correct answer is 'Hypotension and Angina.' Norvasc is a medication known to cause hypotension (low blood pressure) and angina (chest pain) as side effects. These side effects are important for the patient to watch out for as they can indicate potential issues related to the medication. Choice B ('Hypertension') is incorrect as Norvasc is actually used to treat hypertension, not cause it. Choice C ('Lower extremity edema') is not a common side effect of Norvasc. Choice D ('Peripheral sensory loss and SOB') is not typically associated with Norvasc's side effects.

5. When choosing a needle gauge for an intramuscular injection in a 12-year-old boy, which of the following gauges would you choose?

• A. 27 gauge
• B. 25 gauge
• C. 22 gauge
• D. 20 gauge

Correct answer: C

Rationale: The correct answer is 22 gauge. A 22-gauge needle is recommended for school-age children, toddlers, and adolescents due to their muscle mass and tolerance. In infants, a smaller gauge (23-25) is preferred as their muscles are less developed and more sensitive. Choice A, 27 gauge, is too thin for an intramuscular injection in a 12-year-old boy. Choice B, 25 gauge, is more suitable for infants than for a 12-year-old. Choice D, 20 gauge, is too thick and not typically used for intramuscular injections in children.

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