Nursing Elites

1. The nurse is teaching a group of clients about managing diabetes. Which of the following should be emphasized as a goal for all diabetics?

• A. Frequent exercise and weight control
• B. Prevent eye damage
• C. Keep insulin refrigerated at all times
• D. Prevent the development of complications

Correct answer: A

Rationale: The correct answer is A: Frequent exercise and weight control. These should be emphasized as a goal for all diabetics because they help prevent complications and manage blood sugar levels. Regular physical activity and maintaining a healthy weight are crucial in managing diabetes as they can improve insulin sensitivity, regulate blood sugar levels, and reduce the risk of cardiovascular complications. Choice B, preventing eye damage, is important but is more specific to diabetic retinopathy and not a general goal for all diabetics. Choice C, keeping insulin refrigerated, is essential for insulin storage but not a primary goal for all diabetics. Choice D, preventing the development of complications, is too broad and does not provide a specific actionable goal for all diabetics.

2. A client recently started on warfarin therapy. What laboratory value is most important to monitor for this client?

• A. Platelet count
• B. Prothrombin time (PT)
• C. Creatinine level
• D. Blood urea nitrogen (BUN)

Correct answer: B

Rationale: Prothrombin time (PT) is the most important laboratory value to monitor for clients on warfarin therapy. PT helps determine how long it takes blood to clot and ensures the warfarin dose is within the therapeutic range to prevent either excessive bleeding or clotting. Monitoring platelet count is important for assessing the risk of bleeding, but PT is more specific to warfarin therapy. Creatinine level and BUN are indicators of kidney function and are not directly related to warfarin therapy.

3. A client with tuberculosis (TB) is being discharged on isoniazid and rifampin. What instruction should the nurse prioritize?

• A. Complete the full course of antibiotics.
• B. Notify the healthcare provider if you experience tingling in your fingers.
• C. Use a disposable mask when in contact with others.
• D. Monitor liver function tests monthly.

Correct answer: C

Rationale: The correct answer is to instruct the client to use a disposable mask when in contact with others. TB is highly contagious, and wearing a mask can help prevent the spread of the disease to others. Choice A is important but not the priority as using a mask directly impacts public health. Choice B is related to a potential side effect of isoniazid, peripheral neuropathy, but immediate healthcare provider notification is not required. Choice D is relevant due to the potential hepatotoxicity of isoniazid and rifampin, but it is not the priority instruction in this scenario.

4. The nurse is assessing a client 2 hours postoperatively following an appendectomy. The nurse should intervene for which abnormal finding?

• A. Heart rate of 88 beats per minute
• B. Blood pressure of 100/60
• C. Oxygen saturation of 94%
• D. Respiratory rate of 16

Correct answer: C

Rationale: The correct answer is C. Oxygen saturation levels below 95% indicate hypoxia and require immediate intervention. A heart rate of 88 beats per minute, a blood pressure of 100/60, and a respiratory rate of 16 are within normal ranges and do not require immediate intervention. Oxygen saturation is a critical parameter reflecting the client's oxygenation status.

5. A client with acute pancreatitis is receiving nothing by mouth (NPO) status. What is the nurse's priority intervention?

• A. Administer antiemetic medication as prescribed.
• B. Monitor the client's intake and output.
• C. Provide mouth care to keep the client comfortable.
• D. Elevate the client's head of the bed.

Correct answer: B

Rationale: The correct answer is B: Monitor the client's intake and output. When a client with acute pancreatitis is on NPO status, the nurse's priority intervention is to monitor the client's intake and output. This is crucial to assess for signs of dehydration, electrolyte imbalances, and to ensure the client is responding appropriately to treatment. Administering antiemetic medication (choice A) may be necessary for managing nausea and vomiting but is not the priority over monitoring intake and output. Providing mouth care (choice C) and elevating the client's head of the bed (choice D) are important aspects of care but do not take precedence over monitoring intake and output to prevent complications in clients with NPO status due to acute pancreatitis.

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