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1. The nurse is assessing a 22-year-old patient experiencing the onset of symptoms of type 1 diabetes. Which question is most appropriate for the nurse to ask?
- A. "Are you anorexic?"
- B. "Is your urine dark colored?"
- C. "Have you lost weight lately?"
- D. "Do you crave sugary drinks?"
Correct answer: C
Rationale: Weight loss is a common symptom in the onset of type 1 diabetes due to the body's inability to use glucose for energy. The lack of insulin leads the body to break down fat and muscle for fuel, causing unintentional weight loss. This is a more relevant question compared to the others, as it directly relates to the metabolic changes associated with type 1 diabetes.
2. A registered nurse (RN) is caring for a patient who is one of Jehovah�s Witnesses and has refused a blood transfusion even though her hemoglobin is dangerously low. After providing information about all the alternatives available and risks and benefits of each, the health-care provider allows the patient to determine which course of treatment she would prefer. The RN knows this is an example of which ethical principle?
- A. Autonomy
- B. Nonmaleficence
- C. Beneficence
- D. Distributive justice
Correct answer: A
Rationale: This is an example of the ethical principle of autonomy.
3. A few weeks after an 82-year-old with a new diagnosis of type 2 diabetes has been placed on metformin (Glucophage) therapy and taught about appropriate diet and exercise, the home health nurse makes a visit. Which finding by the nurse is most important to discuss with the healthcare provider?
- A. Hemoglobin A1C level is 7.9%.
- B. Last eye exam was 18 months ago.
- C. Glomerular filtration rate is decreased.
- D. Patient has questions about the prescribed diet.
Correct answer: C
Rationale: The most important finding to discuss with the healthcare provider is the decreased glomerular filtration rate. In patients on metformin therapy, monitoring kidney function is crucial as metformin is primarily excreted through the kidneys. A decreased glomerular filtration rate can lead to metformin accumulation in the body, increasing the risk of lactic acidosis, a serious adverse effect. The hemoglobin A1C level being 7.9% indicates poor diabetes control but can be addressed through medication adjustments and lifestyle modifications. The patient needing an eye exam after 18 months is important but not as urgent as discussing the decreased glomerular filtration rate. Patient questions about the prescribed diet can be addressed during the visit without the need for immediate healthcare provider intervention.
4. Which of the following is used as an indirect estimate of voluntary absenteeism?
- A. Involuntary absenteeism
- B. Voluntary absenteeism
- C. Total time lost
- D. Absence frequency
Correct answer: D
Rationale: The correct answer is 'Absence frequency.' Absence frequency is the total number of distinct absence periods, regardless of duration. It is used as an indirect estimate of voluntary absenteeism because it provides insights into the frequency of absences. Voluntary absenteeism refers to absences that are under the employee's control, while involuntary absenteeism is not under their control. Total time lost, on the other hand, represents the number of scheduled days that employees miss, which is different from absence frequency.
5. Which of the following is a challenge the profession of nursing faced?
- A. Nursing contributing to the stigma of AIDS in the 1980s out of fear.
- B. Nursing practice flourishing in field hospitals during the Korean War with abundant supplies and equipment.
- C. Many nurses feeling frustrated with the lack of independent functioning after the Vietnam War.
- D. A decline in the number of hospice nurses due to ethical dilemmas.
Correct answer: C
Rationale: The correct answer is C. After the Vietnam War, many nurses felt frustrated with the lack of independent functioning when they returned home. This challenge was faced by the profession of nursing as nurses who functioned independently in mobile hospital units during the war found themselves restricted in their practice upon returning. Choices A, B, and D are incorrect because they do not address the specific challenge of lack of independent functioning faced by nurses after the Vietnam War.
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