Nursing Elites

1. Which insulin has the most rapid onset of action?

• A. Lente
• B. Lispro
• C. Ultralente
• D. Humulin N

Correct answer: B

Rationale: Lispro insulin has the most rapid onset of action among the options provided. It is a rapid-acting insulin analog that is designed to control postprandial hyperglycemia effectively. Lente insulin (Choice A) and Ultralente insulin (Choice C) are intermediate-acting insulins, which have a slower onset of action compared to Lispro. Humulin N (Choice D) is a neutral protamine Hagedorn (NPH) insulin, which is an intermediate-acting insulin, not rapid-acting like Lispro. Therefore, the correct choice is Lispro.

2. Which individual is most at risk for Osgood-Schlatter disease?

• A. An elderly female who is hospitalized with a hip fracture and on bed rest
• B. A middle-aged male patient who has been exposed to asbestos in the shipping industry
• C. An adolescent who is physically active and the captain of their soccer team
• D. An infant of low birth weight and a gestational age of 28 weeks

Correct answer: C

Rationale: Osgood-Schlatter disease is a condition that commonly affects adolescents who are physically active, especially during growth spurts. It is caused by overuse of the knee, leading to inflammation of the patellar ligament at the tibial tuberosity. The repetitive stress on the growth plate during activities like running and jumping can trigger this condition. Therefore, an adolescent who is physically active and the captain of their soccer team is most at risk for Osgood-Schlatter disease. Choices A, B, and D are not at high risk for this condition as it is primarily seen in active adolescents.

3. Multifetal pregnancies with triplets occur at a rate of 1 in 8,100 births, but twins occur much more frequently with a rate of:

• A. 1 in 85 births.
• B. 1 in 5400 births.
• C. 1 in 2700 births.
• D. 1 in 540 births

Correct answer: A

Rationale: The correct answer is A: 1 in 85 births. The rate of twin pregnancies is approximately 1 in 85 births. This means that twins are more common compared to triplets, which occur at a rate of 1 in 8,100 births. Choices B, C, and D are incorrect because they do not reflect the correct frequency of twin pregnancies as stated in the question.

4. A charge nurse making rounds observes that an assistive personnel (AP) has applied wrist restraints to a client who is agitated and does not have a prescription for restraints. Which of the following actions should the nurse take first?

• A. Remove the restraints from the client's wrists
• B. Review the chart for nonrestraint alternatives for agitation
• C. Speak with the AP about the incident
• D. Inform the unit manager of the incident

Correct answer: A

Rationale: The correct action for the nurse to take first is to remove the restraints from the client's wrists. Restraints should not be applied without a prescription due to the risk of harm to the client. Removing the restraints promptly is a priority to ensure the client's safety. Reviewing nonrestraint alternatives, speaking with the AP, and informing the unit manager can follow after ensuring the client's immediate safety by removing the restraints.

5. A nurse in the emergency department is performing triage for a group of clients who were in a train crash. Which of the following clients should the nurse tag as emergent?

• A. A client who has an open fracture of the femur
• B. A client who has periorbital ecchymosis
• C. A client who has asymmetrical thorax
• D. A client who has a deep-partial thickness burn on the lower extremities

Correct answer: C

Rationale: In a triage situation, an asymmetrical thorax suggests a potentially life-threatening condition such as a pneumothorax or hemothorax, requiring immediate attention. This client should be tagged as emergent. Periorbital ecchymosis and deep-partial thickness burns, while concerning, may not indicate an immediate life-threatening situation. An open fracture of the femur, although serious, can be prioritized after addressing emergent cases.

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