Nursing Elites

1. The client with type 2 DM is receiving dietary instructions from the nurse regarding the prescribed diabetic diet. The nurse determines that the client understands the instructions if the client states that:

• A. I need to skip meals if my blood glucose level is elevated.
• B. I need to eat a small meal or snack every 2 to 3 hours.
• C. I need to avoid using concentrated sweets in my diet.
• D. I need to eat a high-protein, low-carbohydrate diet.

Correct answer: C

Rationale: The correct answer is C: 'I need to avoid using concentrated sweets in my diet.' Clients with type 2 diabetes should avoid concentrated sweets as they can cause rapid spikes in blood glucose levels, which can be detrimental to their health. Option A is incorrect because skipping meals can lead to fluctuations in blood glucose levels. Option B is incorrect as it does not address the specific issue of avoiding concentrated sweets. Option D is incorrect because a high-protein, low-carbohydrate diet is not typically recommended as the primary approach for managing type 2 diabetes.

2. A nurse manager is reviewing the nurse’s documentation on the unit. Which of the following best describes the importance of this review?

• A. The nurse manager’s review of documentation is crucial to ensure that it meets legal and ethical standards and accurately reflects the care provided to patients.
• B. The nurse manager’s review of documentation is important to ensure that it is thorough, accurate, and reflects the nurse’s accountability for patient care.
• C. The nurse manager’s review of documentation is necessary to ensure that it is consistent with the unit’s policies and procedures and that it accurately reflects the care provided.
• D. The nurse manager’s review of documentation is essential to ensure that it meets regulatory requirements and that it supports the delivery of safe and effective patient care.

Correct answer: D

Rationale: The nurse manager's review of documentation is a critical aspect of maintaining quality patient care. Choice D is the correct answer as it highlights the importance of ensuring that documentation meets regulatory requirements, supporting the delivery of safe and effective patient care. Regulatory requirements are established to ensure that healthcare facilities function within established guidelines and standards, promoting patient safety and quality of care. Choices A, B, and C, although important aspects of documentation review, do not fully encapsulate the significant role of regulatory compliance in ensuring the overall quality and safety of patient care.

3. The client with type 1 diabetes mellitus is being educated by the nurse about the signs of hypoglycemia. Which of the following symptoms should the client be instructed to report immediately?

• A. Shakiness
• B. Sweating
• C. Confusion
• D. Increased thirst

Correct answer: C

Rationale: Confusion is a critical symptom of hypoglycemia that may indicate a more severe drop in blood glucose levels. Immediate reporting of confusion is crucial as it could progress rapidly to unconsciousness or seizures, necessitating prompt intervention. Shakiness and sweating are common early signs of hypoglycemia but may not require immediate intervention unless other severe symptoms present. Increased thirst is more indicative of hyperglycemia rather than hypoglycemia, and while it should be monitored, it is not a symptom requiring immediate reporting.

4. When should a new nurse graduate consider applying for a position as a nurse manager?

• A. When she is comfortable in her current position
• B. When she begins mentoring other new nurses
• C. As soon as a position opens
• D. When she has developed leadership and clinical expertise

Correct answer: D

Rationale: A new nurse graduate should consider applying for a nurse manager position when they have developed both leadership and clinical expertise. This ensures that they are well-prepared for the responsibilities of the role. Choice A is incorrect because being comfortable in the current position does not necessarily equate to having the required skills for a nurse manager role. Choice B is incorrect as mentoring other new nurses, while valuable, may not directly align with the skills needed for a managerial position. Choice C is incorrect as applying for a nurse manager position solely because a position is available does not guarantee readiness for the role.

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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