Nursing Elites

1. The client with type 2 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: Uncontrolled blood glucose levels are associated with an increased risk of cardiovascular complications, such as heart disease and stroke. High blood glucose levels can damage blood vessels over time, leading to atherosclerosis, which can increase the likelihood of heart disease and stroke. Improved wound healing (choice B) is not a consequence of uncontrolled blood glucose levels; in fact, high blood sugar levels can impair wound healing. Reduced need for medication (choice C) is inaccurate because uncontrolled blood glucose usually necessitates more medication to manage the condition. Decreased risk of infection (choice D) is also misleading as high blood glucose levels can compromise the immune system, making individuals more susceptible to infections.

2. A client with type 2 diabetes mellitus is being discharged after receiving initial treatment. What should the nurse emphasize as a crucial instruction?

• A. Take insulin as prescribed, even if you are not eating.
• B. Avoid all forms of physical exercise to prevent hypoglycemia.
• C. Monitor blood glucose levels regularly and report any changes.
• D. Stop taking oral antidiabetic medication if your blood glucose levels are normal.

Correct answer: C

Rationale: Monitoring blood glucose levels regularly is a critical aspect of managing type 2 diabetes mellitus. This allows the individual to track their blood sugar levels, understand the effectiveness of the treatment plan, and detect any fluctuations promptly. Option A is incorrect because insulin should be taken based on a prescribed schedule that correlates with meals to prevent hypoglycemia or hyperglycemia. Option B is incorrect as physical exercise is beneficial for managing diabetes but should be done cautiously with adjustments in insulin or food intake. Option D is incorrect because discontinuing oral antidiabetic medications without healthcare provider guidance can lead to uncontrolled blood glucose levels.

3. A healthcare professional is experiencing moral distress due to an ethical dilemma. Which of the following best describes the healthcare professional’s response to this situation?

• A. The healthcare professional is experiencing moral distress because the ethical dilemma is causing a conflict between the healthcare professional’s personal values and professional responsibilities.
• B. The healthcare professional is experiencing moral distress because the ethical dilemma is causing a conflict between the healthcare professional’s obligations to the patient and the healthcare team.
• C. The healthcare professional is experiencing moral distress because the ethical dilemma is causing a conflict between the healthcare professional’s personal beliefs and the expectations of the healthcare organization.
• D. The healthcare professional is experiencing moral distress because the ethical dilemma is causing a conflict between the healthcare professional’s professional judgment and the wishes of the patient’s family.

Correct answer: A

Rationale: Moral distress occurs when a healthcare professional experiences a conflict between personal values and professional responsibilities, leading to emotional and ethical challenges. Choice B is incorrect because moral distress is primarily related to personal values and professional responsibilities, not just obligations to the patient and healthcare team. Choice C is incorrect because moral distress is more about personal values and professional responsibilities, rather than organizational expectations. Choice D is incorrect because moral distress is focused on personal values and professional responsibilities, not just conflicts with the wishes of the patient’s family.

4. A client with Cushing's syndrome is being monitored for complications. Which of the following findings should the nurse report to the healthcare provider immediately?

• A. Hypertension
• B. Hyperglycemia
• C. Low-grade fever
• D. Weight gain

Correct answer: C

Rationale: The correct answer is C: Low-grade fever. A low-grade fever may indicate an infection, which is a serious concern in clients with Cushing's syndrome due to their immunosuppressed state. Hypertension and hyperglycemia are common manifestations of Cushing's syndrome and may not require immediate reporting unless severe or uncontrolled. Weight gain is also a common symptom in clients with Cushing's syndrome and may not warrant immediate reporting unless it is sudden and significant.

5. Which of the following actions by the healthcare provider would be considered false imprisonment?

• A. The healthcare provider tells the client they are not allowed to leave until the physician has released them.
• B. The healthcare provider asks the client why they wish to leave.
• C. The healthcare provider asks the client to explain what they understand about their medical diagnosis.
• D. The healthcare provider asks the client to sign an against medical advice discharge form.

Correct answer: A

Rationale: The correct answer is A. False imprisonment occurs when a healthcare provider restrains a client from leaving against their will, even if the provider believes it is in the client's best interest. In this scenario, telling the client they are not allowed to leave until the physician has released them constitutes false imprisonment as it restricts the client's freedom of movement. Choice B is incorrect because asking the client why they wish to leave is a form of assessment and does not involve restraining the client. Choice C is incorrect as it pertains to educating the client about their medical condition. Choice D is incorrect because asking the client to sign an against medical advice discharge form is a legal and ethical procedure to ensure the client understands the risks of leaving against medical advice.

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