Nursing Elites

1. What are the common complications of diabetes, and how should they be managed?

• A. Retinopathy and nephropathy; manage with regular screening
• B. Neuropathy and cardiovascular disease; manage with medication
• C. Foot ulcers and hypertension; manage with proper foot care
• D. Hypertension and liver disease; manage with insulin therapy

Correct answer: A

Rationale: The correct answer is A. Common complications of diabetes include retinopathy (damage to the retina) and nephropathy (kidney damage). These complications can be managed effectively with regular screening to detect any signs early on. Choice B is incorrect as neuropathy and cardiovascular disease are other complications of diabetes but are managed through various treatments and lifestyle modifications, not just medication. Choice C is incorrect as although foot ulcers and hypertension are associated with diabetes, the management involves proper foot care practices and blood pressure control, respectively. Choice D is incorrect as hypertension and liver disease are not the typical complications of diabetes, and insulin therapy is not the primary management for these conditions.

2. What advice should be given to a client experiencing constipation?

• A. Encourage the client to drink water frequently
• B. Increase dietary fiber to relieve constipation
• C. Administer a laxative to relieve discomfort
• D. Encourage the client to increase physical activity

Correct answer: B

Rationale: The correct advice to give to a client experiencing constipation is to increase dietary fiber. Dietary fiber helps relieve constipation by promoting regular bowel movements. Encouraging the client to drink water frequently (Choice A) is also important for overall bowel health, but increasing dietary fiber is more directly related to relieving constipation. Administering a laxative (Choice C) should not be the first-line recommendation and should only be considered if dietary and lifestyle changes do not work. Encouraging the client to increase physical activity (Choice D) can be beneficial for overall health but may not directly address the issue of constipation.

3. A nurse is contributing to the plan of care for a client who has a chest tube connected to a closed drainage system. Which of the following interventions should the nurse include?

• A. Clamp the chest tube
• B. Maintain the drainage below the level of the chest
• C. Elevate the chest tube above chest level
• D. Avoid frequent dressing changes

Correct answer: B

Rationale: The correct intervention for a client with a chest tube connected to a closed drainage system is to maintain the drainage below the level of the chest. This position allows proper drainage of fluids and helps prevent complications such as backflow of blood or fluids into the chest cavity. Clamping the chest tube (Choice A) is incorrect as it can lead to a tension pneumothorax. Elevating the chest tube above chest level (Choice C) is also incorrect because it can impede proper drainage. Avoiding frequent dressing changes (Choice D) is important to prevent introducing infection, but it is not directly related to the position of the drainage system.

4. A client is given morphine 6 mg IV push for postoperative pain. Following administration of this drug, the nurse observes the following: pulse 68, respirations 8, BP 100/68, client sleeping quietly. Which of the following nursing actions is MOST appropriate?

• A. Allow the client to sleep undisturbed
• B. Administer oxygen via facemask or nasal prongs
• C. Administer naloxone (Narcan)
• D. Place epinephrine 1:1,000 at the bedside

Correct answer: C

Rationale: The correct answer is to administer naloxone (Narcan). The client's vital signs indicate opioid-induced respiratory depression, which is a potential side effect of morphine. Naloxone is used to reverse the effects of opioids, particularly to restore normal respiratory function. Administering oxygen alone (Choice B) may not address the underlying cause of respiratory depression. Allowing the client to sleep undisturbed (Choice A) is inappropriate when signs of respiratory depression are present. Epinephrine (Choice D) is not indicated in this situation and is not used to reverse opioid effects.

5. A nurse is receiving report on four clients. Which of the following clients should the nurse plan to see first?

• A. A client who is NPO and has dry mucous membranes
• B. A client with rotavirus who has been vomiting
• C. A client who has a urinary catheter and cloudy urine
• D. A client who has pneumonia and a new onset of confusion

Correct answer: D

Rationale: The correct answer is D because a client with pneumonia and a new onset of confusion needs immediate evaluation for changes in neurological status. This could indicate a decline in respiratory status or potential complications such as hypoxia or sepsis. Option A, a client who is NPO and has dry mucous membranes, may need intervention but does not indicate an acute change in condition. Option B, a client with rotavirus who has been vomiting, requires assessment and intervention but does not pose an immediate threat to life. Option C, a client with a urinary catheter and cloudy urine, may indicate a urinary tract infection but does not require immediate attention compared to the client with new onset confusion and pneumonia.

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