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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. What is the primary focus of the Institute for Healthcare Improvement (IHI)?
- A. Patient safety
- B. Cost reduction
- C. Healthcare innovation
- D. Research funding
Correct answer: A
Rationale: The primary focus of the Institute for Healthcare Improvement (IHI) is patient safety. IHI is renowned for its efforts in developing and implementing evidence-based practices to enhance patient safety and improve the quality of care in healthcare settings. While cost reduction, healthcare innovation, and research funding are important aspects of healthcare, the core mission of the IHI revolves around prioritizing patient safety. Patient safety involves reducing medical errors, improving care processes, and creating a safer environment for patients, which are all fundamental to the work of the IHI.
3. A client requires a 24-hr urine collection. Which of the following statements by the client indicates an understanding of the teaching?
- A. ''I had a bowel movement, but I was able to save the urine.''
- B. ''I have a specimen in the bathroom from about 30 minutes ago.''
- C. ''I drink a lot, so I will fill up the bottle and complete the test quickly.''
- D. ''I flushed what I urinated at 7:00 a.m. and have saved all urine since.''
Correct answer: C
Rationale: Option C demonstrates an understanding of the need to collect urine over 24 hours. The client's statement shows awareness that increased fluid intake will help in filling up the collection bottle quickly, which is essential for an accurate test result. This choice reflects the correct understanding of the teaching. Options A, B, and D do not reflect the necessary comprehension for a 24-hr urine collection process. Option A involves a bowel movement, which is not relevant to a urine collection. Option B only mentions a specimen from 30 minutes ago, not over a 24-hour period. Option D indicates flushing urine, which contradicts the idea of saving all urine for the test.
4. The nurse is taking a health history from a 29-year-old pregnant patient at the first prenatal visit. The patient reports no personal history of diabetes but has a parent who is diabetic. Which action will the nurse plan to take first?
- A. Teach the patient about administering regular insulin.
- B. Schedule the patient for a fasting blood glucose level.
- C. Discuss an oral glucose tolerance test for the twenty-fourth week of pregnancy.
- D. Provide teaching about an increased risk for fetal problems with gestational diabetes.
Correct answer: B
Rationale: The correct answer is B. Given the family history of diabetes, the initial action the nurse should take is to schedule the patient for a fasting blood glucose level. This will help in assessing if the patient has developed gestational diabetes. Choice A is incorrect because teaching about administering regular insulin is premature without confirming the diagnosis. Choice C is incorrect as an oral glucose tolerance test is typically done earlier in pregnancy. Choice D is incorrect as discussing fetal problems related to gestational diabetes should come after a confirmed diagnosis.
5. What is the main focus of the Magnet Recognition Program?
- A. Nurse satisfaction
- B. Patient outcomes
- C. Financial performance
- D. Nursing excellence
Correct answer: D
Rationale: The main focus of the Magnet Recognition Program is nursing excellence. While nurse satisfaction and patient outcomes are important aspects influenced by the program, the primary goal is to recognize and promote nursing excellence. Financial performance is not the main focus of this program.
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