Nursing Elites

1. Which fact about diabetes is true?

• A. Only children get type 1 diabetes.
• B. Only adults get type 2 diabetes.
• C. Children and adults can have type 1 diabetes.
• D. Both A and B

Correct answer: C

Rationale: The correct answer is that children and adults can have type 1 diabetes. Although type 1 diabetes is sometimes known as 'childhood diabetes,' it can affect individuals of any age. Type 1 diabetes is not limited to children. While type 2 diabetes is often associated with adults, children can also develop it, especially due to factors like obesity. Choices A and B are incorrect because diabetes is not exclusive to either children or adults; both types of diabetes can affect individuals across different age groups.

2. You are responsible for reviewing the nursing unit's refrigerator. Which of the following drugs, if found inside the fridge, should be removed?

• A. Nadolol (Corgard)
• B. Opened (in-use) Humulin N injection
• C. Urokinase (Kinlytic)
• D. Epoetin alfa IV (Epogen)

Correct answer: A

Rationale: Nadolol (Corgard) should be removed if found inside the fridge because it is supposed to be stored at room temperature between 59 to 86 �F (15 and 30 �C) away from heat, moisture, and light. Storing it in the refrigerator can alter its effectiveness and stability. Option B, the opened Humulin N injection, should not be stored in the refrigerator as it is an in-use product and can remain at room temperature for a certain period as per manufacturer guidelines. Option C, Urokinase (Kinlytic), and Option D, Epoetin alfa IV (Epogen), do not require refrigeration and can be stored at room temperature. Therefore, Nadolol (Corgard) is the drug that should be removed from the fridge.

3. A female patient with atrial fibrillation has the following lab results: Hemoglobin of 11 g/dl, a platelet count of 150,000, an INR of 2.5, and potassium of 2.7 mEq/L. Which result is critical and should be reported to the physician immediately?

• A. Hemoglobin of 11 g/dl
• B. Platelet count of 150,000
• C. INR of 2.5
• D. Potassium of 2.7 mEq/L

Correct answer: D

Rationale: The critical lab result that should be reported to the physician immediately in this case is the potassium level of 2.7 mEq/L. A potassium imbalance, especially in a patient with a history of dysrhythmia like atrial fibrillation, can be life-threatening and lead to cardiac distress. Low potassium levels (hypokalemia) can predispose the patient to dangerous arrhythmias, including worsening atrial fibrillation. Hemoglobin of 11 g/dl, platelet count of 150,000, and an INR of 2.5 are within acceptable ranges and not as immediately concerning as a low potassium level in this clinical context.

4. During your evaluation of a 14-year-old girl with a BMI of 18, she reports inability to eat, induced vomiting, and severe constipation. Which of the following would you most likely suspect?

• A. Multiple sclerosis
• B. Anorexia nervosa
• C. Bulimia nervosa
• D. Systemic sclerosis

Correct answer: B

Rationale: The clinical presentation described in the question is highly suggestive of anorexia nervosa. Anorexia nervosa is characterized by self-imposed starvation due to a distorted body image and an intense fear of gaining weight, even when the individual is underweight. The patient's symptoms of inability to eat, induced vomiting, and severe constipation align with the behavior seen in anorexia nervosa, including restrictive eating patterns and purging behaviors. Multiple sclerosis (Choice A) is a neurological disorder, not associated with the described symptoms. Bulimia nervosa (Choice C) typically involves binge eating followed by purging behaviors, which is different from the described primary restriction seen in anorexia nervosa. Systemic sclerosis (Choice D) is a connective tissue disorder and is not related to the symptoms of self-induced vomiting and severe constipation reported in this case.

5. Renal failure is broadly divided into specific categories. Which type is the type II diabetic patient most likely to experience secondary to diabetes?

• A. Acute renal failure (ARF)
• B. Intermittent renal failure (IRF)
• C. Chronic renal failure (CRF)
• D. Reversible renal failure (RRF)

Correct answer: C

Rationale: Diabetic nephropathy is a common complication in type II diabetic patients, leading to chronic renal failure (CRF). Chronic renal failure (CRF) and acute renal failure (ARF) are the two main categories of renal failure. CRF can result from various conditions including diabetic nephropathy, chronic glomerulonephritis, chronic pyelonephritis, polycystic kidney disease, connective tissue disorders, and amyloidosis. Unlike acute renal failure, chronic renal failure is irreversible. Timely treatment of ARF can often lead to reversibility, but CRF may require renal replacement therapy (RRT) or kidney transplant. Therefore, the correct answer is chronic renal failure (CRF). Intermittent renal failure (IRF) and reversible renal failure (RRF) are not recognized medical terms for distinct types of renal failure, making choices B and D incorrect.

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