Nursing Elites

1. What is the lowest fasting plasma glucose level suggestive of a diagnosis of DM?

• A. 90 mg/dl.
• B. 115 mg/dl.
• C. 126 mg/dl.
• D. 180 mg/dl.

Correct answer: C

Rationale: A fasting plasma glucose level of 126 mg/dl or higher is diagnostic of diabetes mellitus. Choice A (90 mg/dl) is too low to indicate diabetes. Choice B (115 mg/dl) is also below the diagnostic threshold for diabetes. Choice D (180 mg/dl) is above the diagnostic threshold and would indicate uncontrolled diabetes, not the lowest level suggestive of a diagnosis.

2. A client is admitted to the ER with DKA. In the acute phase, the priority nursing action is to prepare to:

• A. Administer regular insulin intravenously
• B. Administer 5% dextrose intravenously
• C. Correct the acidosis
• D. Apply an electrocardiogram monitor

Correct answer: A

Rationale: Administering regular insulin intravenously is the priority nursing action in the acute phase of DKA. Insulin helps to lower blood glucose levels by promoting cellular uptake of glucose and inhibiting ketone production. Administering dextrose would be counterproductive as it can worsen hyperglycemia. Correcting acidosis is important but usually follows insulin administration. Applying an electrocardiogram monitor is not the priority action in the acute management of DKA.

3. An RN enters a patient's room to place an indwelling urinary catheter, as ordered by the healthcare professional. The client is alert and oriented and tells the RN he wants to leave the hospital now and not receive further treatment. Which of the following actions by the RN would be considered false imprisonment?

• A. The RN tells the client he is not allowed to leave until the physician has released him.
• B. The RN asks the client why he wishes to leave.
• C. The RN asks the client to explain what he understands about his medical diagnosis.
• D. The RN asks the client to sign an against medical advice discharge form.

Correct answer: A

Rationale: False imprisonment occurs when a person is prevented from leaving against their will. By telling the patient they are not allowed to leave, the RN is restricting the patient’s freedom unlawfully. Choice B is focused on understanding the patient's reasons for leaving and does not involve restricting the patient's freedom. Choice C aims to assess the patient's understanding of their medical condition, which is unrelated to false imprisonment. Choice D involves obtaining consent for leaving against medical advice, which is a legal and ethical process and not false imprisonment.

4. Early this morning, a female client had a subtotal thyroidectomy. During evening rounds, Nurse Tina assesses the client, who now has nausea, a temperature of 105°F (40.5°C), tachycardia, and extreme restlessness. What is the most likely cause of these signs?

• A. Diabetic ketoacidosis
• B. Thyroid crisis
• C. Hypoglycemia
• D. Tetany

Correct answer: B

Rationale: The correct answer is B: Thyroid crisis. Thyroid crisis, also known as thyroid storm, is a life-threatening condition that can occur after a thyroidectomy. Symptoms include high fever, tachycardia, extreme restlessness, and other signs of severe hyperthyroidism. Diabetic ketoacidosis (choice A) is a complication of diabetes characterized by hyperglycemia, ketosis, and acidosis, not typically seen post-thyroidectomy. Hypoglycemia (choice C) is low blood sugar levels and would not present with the symptoms described. Tetany (choice D) is a condition of involuntary muscle spasms due to low calcium levels and is not directly related to the symptoms observed in this scenario.

5. A client with diabetes mellitus is experiencing symptoms of hypoglycemia. The nurse should instruct the client to do which of the following?

• A. Eat a high-protein snack
• B. Consume 15 grams of simple carbohydrates
• C. Drink a glass of water
• D. Administer an extra dose of insulin

Correct answer: B

Rationale: Consuming 15 grams of simple carbohydrates is the recommended treatment for mild hypoglycemia to quickly raise blood sugar levels. Simple carbohydrates are rapidly absorbed and provide a quick source of glucose to combat low blood sugar. Eating a high-protein snack (Choice A) would delay the rise in blood sugar as proteins take longer to be broken down. Drinking water (Choice C) does not directly address the low blood sugar levels associated with hypoglycemia. Administering an extra dose of insulin (Choice D) would further lower blood sugar levels, worsening the hypoglycemic state.

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