Nursing Elites

1. The nurse has administered 4 oz of orange juice to an alert patient whose blood glucose was 62 mg/dL. Fifteen minutes later, the blood glucose is 67 mg/dL. Which action should the nurse take next?

• A. Give the patient 4 to 6 oz more orange juice.
• B. Administer the PRN glucagon (Glucagon) 1 mg IM.
• C. Have the patient eat some peanut butter with crackers.
• D. Notify the healthcare provider about the hypoglycemia.

Correct answer: A

Rationale: The correct action for the nurse to take next is to give the patient 4 to 6 oz more orange juice. The patient's blood glucose has increased from 62 mg/dL to 67 mg/dL after consuming the initial 4 oz of orange juice, indicating that the treatment is effective. Providing additional orange juice will help further raise the blood glucose levels. Administering glucagon (Choice B) is not necessary as the patient's blood glucose is already rising. Having the patient eat peanut butter with crackers (Choice C) is a slower-acting option compared to orange juice. Notifying the healthcare provider about the hypoglycemia (Choice D) is not needed at this point since the patient's blood glucose is improving.

2. The healthcare provider suspects the Somogyi effect in a 50-year-old patient whose 6:00 AM blood glucose is 230 mg/dL. Which action will the nurse teach the patient to take?

• A. Avoid snacking at bedtime.
• B. Increase the rapid-acting insulin dose.
• C. Check the blood glucose during the night.
• D. Administer a larger dose of long-acting insulin.

Correct answer: C

Rationale: The Somogyi effect, also known as rebound hyperglycemia, occurs due to an excessive insulin dose at night, leading to hypoglycemia in the early morning hours. To address this, the nurse should instruct the patient to check their blood glucose during the night to determine if hypoglycemia is present, which triggers the rebound hyperglycemia. By monitoring blood glucose levels during the night, the patient can identify if adjustments are needed to prevent this phenomenon and maintain stable glucose levels. Choices A, B, and D are incorrect. Avoiding snacking at bedtime, increasing rapid-acting insulin dose, or administering a larger dose of long-acting insulin are not appropriate actions to manage the Somogyi effect. Checking blood glucose during the night is crucial to identify and prevent the rebound hyperglycemia characteristic of this phenomenon.

3. Which of the following best describes the concept of cultural humility in nursing?

• A. A fixed set of cultural competencies
• B. Recognizing and addressing power imbalances
• C. Adapting care to fit different cultural contexts
• D. Learning from patients and adapting to their needs

Correct answer: D

Rationale: Cultural humility in nursing is about approaching patient care with an open mind, being willing to learn from patients, and adapting to their individual needs. Choice A is incorrect as cultural humility is not about a fixed set of competencies, but rather an ongoing process of self-reflection and learning. Choice B, recognizing and addressing power imbalances, is related to cultural competence but not the core concept of cultural humility. Choice C, adapting care to fit different cultural contexts, is more aligned with cultural competence rather than cultural humility.

4. Which of the following presents an important emerging challenge to changes in health care?

• A. Decreased immigration
• B. Nursing staff shortages
• C. Bioterrorism
• D. Increased surgical procedures

Correct answer: C

Rationale: Bioterrorism is considered an important emerging challenge to changes in health care due to its potential to disrupt healthcare systems, cause mass casualties, and create public health emergencies. Choices A, B, and D are not directly related to emerging challenges in health care. While nursing staff shortages are a significant issue, bioterrorism poses a different kind of threat that requires specific preparedness and response strategies.

5. A female patient is scheduled for an oral glucose tolerance test. Which information from the patient�s health history is most important for the nurse to communicate to the health care provider?

• A. The patient uses oral contraceptives.
• B. The patient runs several days a week.
• C. The patient has been pregnant three times
• D. The patient has a family history of diabetes

Correct answer: A

Rationale:

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