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1. Which information will the nurse include when teaching a 50-year-old patient who has type 2 diabetes about glyburide (Micronase, DiaBeta, Glynase)?
- A. Glyburide decreases glucagon secretion from the pancreas.
- B. Glyburide stimulates insulin production and release from the pancreas.
- C. Glyburide should be taken even if the morning blood glucose level is low.
- D. Glyburide should not be used for 48 hours after receiving IV contrast media.
Correct answer: B
Rationale: The correct answer is B: Glyburide stimulates insulin production and release from the pancreas. Glyburide belongs to the sulfonylurea class of antidiabetic medications, which work by stimulating the pancreas to produce and release more insulin. This helps to lower blood glucose levels. Choice A is incorrect because glyburide does not decrease glucagon secretion; instead, it acts on insulin. Choice C is incorrect because taking glyburide when blood glucose is low can lead to hypoglycemia. Choice D is incorrect as there is no specific interaction between glyburide and IV contrast media that requires avoiding its use for 48 hours.
2. A nurse has a seriously ill parent and must take care of the parent at home. Which of the following would NOT be a suitable solution to this problem? (EXCEPT)
- A. Resignation
- B. FMLA
- C. Termination
- D. LOA
Correct answer: C
Rationale: FMLA (Family and Medical Leave Act) provides up to 12 weeks of unpaid, job-protected leave to care for a seriously ill family member, securing the employee's job status. Termination and resignation involve ending employment, which is not a suitable solution as it does not provide job security. LOA (Leave of Absence) is often unpaid and does not guarantee job protection, making it less suitable than FMLA in this scenario.
3. A nurse is evaluating teaching for a client who has heart failure. Which of the following statements by the client indicates an understanding of the teaching?
- A. I am limiting my sodium intake to 2 grams daily.
- B. I have been weighing myself every other morning.
- C. I am trying to decrease my intake of foods with potassium.
- D. I am eating fewer potato chips and more fruit for snacks.
Correct answer: A
Rationale: The correct answer is A. Limiting sodium intake is crucial for clients with heart failure to manage their condition effectively. Excessive sodium can lead to fluid retention and worsen heart failure symptoms. Weighing oneself is important for monitoring fluid retention but does not directly show an understanding of dietary restrictions. Decreasing potassium intake is not typically recommended for heart failure clients unless specifically advised by a healthcare provider. While choosing healthier snacks is beneficial, the focus on sodium intake is more critical for heart failure management.
4. If a staff member does not respond to discipline, the manager must ______ employment.
- A. Terminate
- B. Confront
- C. Describe the staff nurse's behavior that violated the policy
- D. Determine the employee's awareness of the policy
Correct answer: A
Rationale: When an employee does not respond to disciplinary measures, termination may be necessary. This is a last resort for managers when other strategies to improve performance have failed. Terminating an employee means ending their employment with the organization. Choices B, C, and D are incorrect as the question specifically asks what action the manager must take when an employee does not respond to discipline. Confronting the employee, describing the behavior, or determining awareness of the policy are steps that may precede termination but are not the final action to be taken.
5. A client who is postoperative is verbalizing pain as a 2 on a pain scale of 0 to 10. Which of the following statements should the nurse identify as an indication that the client understands the preoperative teaching they received about pain management?
- A. ''I think I should take my pain medication more often, since it is not controlling my pain.''
- B. ''Breathing faster will help me keep my mind off of the pain.''
- C. ''It might help me to listen to music while I'm lying in bed.''
- D. ''I don't want to walk today because I have some pain.''
Correct answer: D
Rationale: The correct answer is D because the client is demonstrating an understanding of the preoperative teaching by acknowledging the pain and relating it to the need to rest. Walking may exacerbate the pain, and the client's decision not to walk shows an awareness of their body's signals. Choices A, B, and C are incorrect as they do not reflect a good understanding of pain management. Choice A suggests self-medicating without consulting healthcare providers, choice B focuses on distraction rather than addressing the pain, and choice C offers a coping mechanism but does not address the pain directly.
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