Nursing Elites

1. The client with DM is being instructed by the nurse about the importance of controlling blood glucose levels. The nurse should emphasize that uncontrolled blood glucose can lead to:

• A. Increased risk of heart disease and stroke.
• B. Improved wound healing.
• C. Reduced need for medication.
• D. Decreased risk of infection.

Correct answer: A

Rationale: The correct answer is A: Increased risk of heart disease and stroke. Uncontrolled blood glucose levels in clients with diabetes mellitus (DM) can lead to cardiovascular complications, such as heart disease and stroke. High blood glucose levels can damage blood vessels over time, increasing the risk of atherosclerosis and cardiovascular events. Choices B, C, and D are incorrect because uncontrolled blood glucose levels do not improve wound healing, reduce the need for medication, or decrease the risk of infection. In fact, uncontrolled blood glucose levels can impair wound healing, require more medications to manage symptoms, and increase the risk of infections due to compromised immune function.

2. Which of the following ethical principles involves the fair and equitable distribution of resources?

• A. Justice
• B. Fidelity
• C. Autonomy
• D. Veracity

Correct answer: A

Rationale: The correct answer is A: Justice. Justice is the ethical principle that focuses on the fair and equitable distribution of resources, ensuring that all individuals receive appropriate care based on their needs. Fidelity (B) refers to being faithful or loyal to commitments and obligations. Autonomy (C) relates to respecting an individual's right to make their own decisions. Veracity (D) pertains to truthfulness and honesty in communication with patients.

3. A client with DM is experiencing symptoms of hypoglycemia. Which action should the nurse take first?

• A. Give the client a glass of orange juice.
• B. Administer insulin as ordered.
• C. Check the client's blood glucose level.
• D. Notify the healthcare provider.

Correct answer: C

Rationale: The correct first action when a client with DM is experiencing symptoms of hypoglycemia is to check the client's blood glucose level. This step is crucial to confirm hypoglycemia before initiating any treatment. Giving the client orange juice (Choice A) is a common intervention for treating hypoglycemia, but it should not be done before confirming the blood glucose level. Administering insulin (Choice B) is not appropriate for hypoglycemia as it would further decrease the blood glucose levels. Notifying the healthcare provider (Choice D) can be important, but the immediate priority is to assess the blood glucose level to guide treatment.

4. 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.

5. The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following clinical manifestations should the nurse expect?

• A. Hypernatremia
• B. Hypotension
• C. Decreased urine output
• D. Polyuria

Correct answer: C

Rationale: The correct answer is C: 'Decreased urine output.' Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by excessive release of antidiuretic hormone, leading to water retention and decreased urine output. Therefore, the nurse should expect the client to have decreased urine output. Choices A, B, and D are incorrect. Hypernatremia (Choice A) is not typically associated with SIADH as it usually leads to dilutional hyponatremia. Hypotension (Choice B) is not a common clinical manifestation of SIADH. Polyuria (Choice D) is the opposite of what is expected in a client with SIADH, who typically presents with decreased urine output.

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