Nursing Elites

1. The client is NPO and is receiving total parenteral nutrition (TPN) via a subclavian line. Which precautions should the nurse implement? Select one that does not apply.

• A. Place the solution on an IV pump at the prescribed rate.
• B. Monitor blood glucose every twelve (12) hours.
• C. Weigh the client weekly, first thing in the morning.
• D. Change the IV tubing every three (3) days.

Correct answer: D

Rationale: Precautions for clients receiving TPN include placing the solution on an IV pump to control the rate, monitoring blood glucose levels to detect hyperglycemia, and monitoring intake and output to assess fluid balance. Changing the IV tubing every three days is not a standard precaution for clients receiving TPN via a subclavian line.

2. Why is it important to control blood glucose levels in type 2 DM?

• A. Hypertension and kidney disease.
• B. Weight gain and obesity.
• C. Improved wound healing.
• D. Decreased cholesterol levels.

Correct answer: A

Rationale: Controlling blood glucose levels in type 2 DM is crucial to prevent complications. High blood glucose levels can lead to hypertension and kidney disease, as seen in diabetic nephropathy and diabetic nephropathy. These are common complications of uncontrolled diabetes. Weight gain and obesity (choice B) are influenced by factors such as diet and physical activity rather than blood glucose levels. Improved wound healing (choice C) is not directly related to blood glucose control but can be affected by it indirectly. Decreased cholesterol levels (choice D) are not a direct consequence of high blood glucose levels and are more related to dietary and lifestyle factors.

3. A client with diabetes insipidus is being treated with desmopressin. The nurse should monitor for which of the following side effects?

• A. Hyponatremia
• B. Hypernatremia
• C. Hypokalemia
• D. Hypercalcemia

Correct answer: A

Rationale: The correct answer is A: Hyponatremia. Desmopressin, a medication used in diabetes insipidus, can cause water retention by increasing water reabsorption in the kidneys. This excess water retention can lead to dilutional hyponatremia, where sodium levels in the body become too low. Monitoring for hyponatremia is crucial to prevent complications such as neurological symptoms. Choices B, C, and D are incorrect because desmopressin is not known to cause hypernatremia, hypokalemia, or hypercalcemia.

4. A nurse manager works hard to keep employee morale high with the thought that this will lead to effective employees doing the best work they can. Which of the following theories does this best describe?

• A. Theory X
• B. Theory Y
• C. Servant leadership
• D. Scientific management

Correct answer: B

Rationale: Theory Y, as proposed by Douglas McGregor, emphasizes that employees are intrinsically motivated and seek responsibility. It suggests that high morale leads to high productivity, aligning with the nurse manager's actions. Theory X, on the other hand, assumes employees are inherently lazy and need to be closely monitored and controlled. Servant leadership focuses on serving others first and prioritizing their needs, which is not directly related to the scenario described. Scientific management, developed by Frederick Taylor, emphasizes efficiency and standardization through systematic study and organizational control, which is not the primary focus of the nurse manager's approach to boosting employee morale.

5. A client with hyperparathyroidism is receiving dietary instructions. Which of the following foods should the client avoid?

• A. Milk
• B. Bananas
• C. Spinach
• D. Processed meats

Correct answer: A

Rationale: In hyperparathyroidism, there are already elevated calcium levels in the body. Therefore, clients should avoid high-calcium foods like milk to prevent further increase in calcium levels. Bananas, spinach, and processed meats do not have significant calcium content and do not need to be avoided specifically in hyperparathyroidism.

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