Nursing Elites

1. The client with type 2 DM is learning to manage blood glucose levels. When should the client monitor blood glucose?

• A. Only when feeling unwell.
• B. Only before meals.
• C. Before meals and at bedtime.
• D. Only after meals.

Correct answer: C

Rationale: The correct answer is to monitor blood glucose before meals and at bedtime. This timing allows the client to assess fasting levels and make informed decisions about mealtime insulin or medication doses. Monitoring only when feeling unwell (choice A) is not sufficient for proper glucose management as it may miss important trends. Monitoring only before meals (choice B) is helpful but does not provide a complete picture of the client's glucose control throughout the day. Monitoring only after meals (choice D) is less beneficial than monitoring before meals as it does not capture fasting levels. Therefore, monitoring before meals and at bedtime (choice C) is the most comprehensive approach to maintain good glucose control and prevent complications.

2. What is the nurse's responsibility when dealing with an impaired colleague?

• A. The nurse should report the colleague to a supervisor and follow the institution's policy for addressing impaired practice.
• B. The nurse should confront the colleague directly and offer support to seek help for the impairment.
• C. Nonmaleficence
• D. The nurse should ignore the colleague's behavior and focus on their own responsibilities.

Correct answer: A

Rationale: When a nurse encounters an impaired colleague, the appropriate action is to report the behavior to a supervisor and follow the institution's policy for addressing impaired practice. This ensures patient safety and upholds professional standards. Choice B is incorrect because confronting the colleague directly may not be appropriate or effective in addressing the issue, and the colleague may need more structured assistance. Choice C is a principle of ethical practice but does not directly address the specific situation of dealing with an impaired colleague. Choice D is incorrect because ignoring the colleague's behavior could potentially compromise patient safety and is not in line with professional responsibility.

3. The healthcare professional is educating a client with Cushing's syndrome about dietary management. Which of the following instructions should the healthcare professional include?

• A. Increase sodium intake
• B. Limit protein intake
• C. Limit calcium intake
• D. Increase potassium intake

Correct answer: D

Rationale: For clients with Cushing's syndrome, they are at risk of developing hypokalemia due to increased excretion of potassium. Therefore, it is essential to advise them to increase their potassium intake. Choices A, B, and C are incorrect because: A) Increasing sodium intake can worsen fluid retention and hypertension common in Cushing's syndrome. B) Limiting protein intake is not necessary unless there are specific kidney issues that require protein restriction. C) Limiting calcium intake is not typically recommended unless there are underlying conditions such as hypercalcemia.

4. A nurse is assigned to care for a group of clients. On reviewing the clients' medical records, the nurse determines that which client is at risk for deficient fluid volume?

• A. A client with a colostomy
• B. A client with congestive heart failure
• C. A client with decreased kidney function
• D. A client receiving frequent wound irrigations

Correct answer: A

Rationale: The correct answer is A. Clients with a colostomy are at risk for deficient fluid volume due to the loss of fluid through the colostomy. In colostomy, there can be increased fluid loss through the stoma, which may lead to dehydration and electrolyte imbalances. Choices B, C, and D do not directly relate to the risk for deficient fluid volume. Clients with congestive heart failure are more prone to fluid overload rather than deficient volume. Clients with decreased kidney function are at risk for fluid retention, not deficient volume. Clients receiving frequent wound irrigations may be at risk for infection, but this does not directly indicate deficient fluid volume.

5. The client has been vomiting and has had numerous episodes of diarrhea. Which laboratory test should the nurse monitor?

• A. Serum calcium.
• B. Serum phosphorus.
• C. Serum potassium.
• D. Serum sodium.

Correct answer: C

Rationale: During episodes of vomiting and diarrhea, there is a risk of significant potassium loss, leading to potential electrolyte imbalances. Monitoring serum potassium levels is crucial in this situation to assess and manage any abnormalities promptly. Serum calcium (Choice A) is not typically affected by vomiting and diarrhea. Serum phosphorus (Choice B) levels are not commonly altered by these symptoms. Serum sodium (Choice D) may be affected in severe cases of dehydration, but potassium monitoring is a higher priority due to its potential for rapid depletion in vomiting and diarrhea.

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