Nursing Elites

1. The school nurse is developing an individualized healthcare plan for a student with type 1 diabetes. Which component is most important to include in the plan?

• A. a schedule for blood glucose monitoring
• B. a list of low-carbohydrate snacks
• C. a contact list of healthcare providers
• D. a log for recording insulin administration

Correct answer: A

Rationale: The correct answer is A: a schedule for blood glucose monitoring. Regular blood glucose monitoring is essential in managing type 1 diabetes as it helps in monitoring blood sugar levels, adjusting treatment plans, and preventing complications such as hypoglycemia or hyperglycemia. Choice B, a list of low-carbohydrate snacks, while important for managing blood sugar levels, is not as critical as consistent blood glucose monitoring. Choice C, a contact list of healthcare providers, though important for emergency situations, is not the most crucial component in managing daily care. Choice D, a log for recording insulin administration, is valuable for tracking insulin doses but does not directly address the immediate need for monitoring blood glucose levels.

2. The nurse is planning a community health fair to promote mental health awareness. Which activity is most likely to engage participants?

• A. a lecture on the signs and symptoms of depression
• B. a workshop on stress management techniques
• C. a panel discussion with mental health experts
• D. a booth distributing brochures on mental health resources

Correct answer: B

Rationale: A workshop on stress management techniques is the most engaging activity as it allows participants to actively participate, learn practical skills, and interact with others. This hands-on approach fosters engagement and provides attendees with tools they can directly apply in their lives. Choice A, a lecture, may be informative but lacks the interactive element that promotes engagement. Choice C, a panel discussion, might be informative but could be passive for attendees. Choice D, distributing brochures, is informative but lacks the interactive and engaging nature of a workshop.

3. The healthcare provider is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which intervention is most important?

• A. Restrict fluids to 1,000 mL per day.
• B. Administer a vasopressin antagonist.
• C. Monitor intake and output.
• D. Encourage a high-sodium diet.

Correct answer: B

Rationale: Administering a vasopressin antagonist is the most critical intervention for a client with SIADH. SIADH is characterized by excessive release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. A vasopressin antagonist helps manage the symptoms by blocking the effects of ADH, promoting water excretion, and restoring electrolyte balance. Restricting fluids (choice A) may exacerbate hyponatremia, monitoring intake and output (choice C) is important but not the most critical intervention, and encouraging a high-sodium diet (choice D) is contraindicated in SIADH due to the risk of worsening hyponatremia.

4. The nurse is providing discharge teaching to a client with a new colostomy. Which statement by the client indicates a need for further teaching?

• A. I will avoid foods that cause gas.
• B. I will change my colostomy bag every week.
• C. I will use a skin barrier to protect the skin around the stoma.
• D. I will empty my colostomy bag when it is one-third full.

Correct answer: B

Rationale: The correct answer is B. Changing the colostomy bag every week is not sufficient; it should be changed more frequently to prevent leakage and skin irritation. Option A is correct as avoiding foods that cause gas can help manage colostomy-related symptoms. Option C is correct as using a skin barrier helps protect the skin around the stoma. Option D is correct as emptying the colostomy bag when it is one-third full helps prevent leakage and discomfort.

5. A client with a history of coronary artery disease is admitted with chest pain. Which assessment finding requires immediate intervention?

• A. Heart rate of 90 beats per minute.
• B. Respiratory rate of 20 breaths per minute.
• C. Blood pressure of 130/80 mm Hg.
• D. Chest pain radiating to the left arm.

Correct answer: D

Rationale: Chest pain radiating to the left arm is a classic symptom of a myocardial infarction (heart attack) in individuals with coronary artery disease. This finding indicates that the heart muscle may not be receiving adequate oxygen, which requires immediate intervention to prevent further damage or complications. The other assessment findings (heart rate of 90 beats per minute, respiratory rate of 20 breaths per minute, blood pressure of 130/80 mm Hg) are within normal limits and do not suggest an acute, life-threatening condition like myocardial infarction.

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