Nursing Elites

1. Which of the following joints normally allows 360-degree circumflexion?

• A. The knee
• B. The shoulder
• C. The elbow
• D. The fingertips

Correct answer: B

Rationale: The correct answer is B: The shoulder. The shoulder joint is a ball-and-socket joint that allows for a wide range of motion, including 360-degree circumflexion. This joint provides flexibility and mobility in various directions. Choice A, the knee joint, primarily allows flexion and extension but does not have a 360-degree circumflexion. Choice C, the elbow joint, is a hinge joint that permits flexion and extension but not circumflexion. Choice D, the fingertips, do not form a specific joint that allows circumflexion; rather, they have joints that enable bending and straightening movements.

2. Which insulin has the most rapid onset of action?

• A. Lente
• B. Lispro
• C. Ultralente
• D. Humulin N

Correct answer: B

Rationale: Lispro insulin has the most rapid onset of action among the options provided. It is a rapid-acting insulin analog that is designed to control postprandial hyperglycemia effectively. Lente insulin (Choice A) and Ultralente insulin (Choice C) are intermediate-acting insulins, which have a slower onset of action compared to Lispro. Humulin N (Choice D) is a neutral protamine Hagedorn (NPH) insulin, which is an intermediate-acting insulin, not rapid-acting like Lispro. Therefore, the correct choice is Lispro.

3. A client with DM states, 'I cannot eat big meals; I prefer to snack throughout the day.' The nurse should carefully explain that the:

• A. Regulated food intake is crucial for control
• B. Restricting salt and sugar is the main concern
• C. Opting for small, frequent meals aids digestion
• D. Consuming large meals can contribute to weight issues

Correct answer: A

Rationale: In clients with diabetes, regulated food intake is crucial for controlling blood glucose levels. Choice A is the correct answer because maintaining consistent meal sizes and timings helps in managing blood sugar levels effectively. Choice B is incorrect because while monitoring salt and sugar intake is important, it is not the primary consideration in this scenario. Choice C is incorrect as the focus is on regulating food intake rather than aiding digestion. Choice D is also incorrect because consuming large meals can indeed lead to fluctuations in blood glucose levels, but the primary concern in this case is the regulation of food intake for better control of diabetes.

4. You are caring for a patient who has no cognitive functioning but only basic human functions such as opening the eyes and the sleep-wake cycle. What level of consciousness does this patient have?

• A. Obtunded
• B. A persistent vegetative state
• C. Locked-in syndrome
• D. Brain death

Correct answer: B

Rationale: A persistent vegetative state is characterized by the absence of cognitive functioning while basic human functions like the sleep-wake cycle are retained. In this state, the patient shows reflex movements and basic responses to stimuli but lacks awareness or higher mental functions. Choices A, C, and D are incorrect because: A) Obtunded refers to a decreased level of consciousness, not the absence of cognitive functioning. C) Locked-in syndrome is a condition where the patient is aware and awake but cannot move or communicate due to complete paralysis of nearly all voluntary muscles except for vertical eye movements and blinking. D) Brain death is the irreversible cessation of all brain activity, including the brainstem, leading to the loss of all functions of the brain.

5. A nurse is caring for a client who reports acute pain but refuses IM medication. The nurse distracts the client and quickly administers the injection. This illustrates which of the following?

• A. Assault
• B. False imprisonment
• C. Battery
• D. Libel

Correct answer: C

Rationale: The correct answer is C, 'Battery.' Administering the injection without the client's consent constitutes battery. Assault involves the threat of harm, not the actual act. False imprisonment is restraining a client against their will, which does not apply here. Libel refers to a false written statement, which is not relevant in this scenario.

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