Nursing Elites

1. Which of the following nursing interventions should be taken for a client who complains of nausea and vomits one hour after taking his glyburide (DiaBeta)?

• A. Administer glyburide again
• B. Administer subcutaneous insulin and monitor blood glucose
• C. Monitor blood glucose closely, and look for signs of hypoglycemia
• D. Monitor blood glucose and assess for signs of hyperglycemia

Correct answer: C

Rationale: After a client complains of nausea and vomits one hour after taking glyburide, the priority nursing intervention should be to monitor blood glucose closely and look for signs of hypoglycemia. Vomiting could indicate that the glyburide was not properly absorbed, potentially leading to hypoglycemia. Administering glyburide again (Choice A) could worsen hypoglycemia. Administering subcutaneous insulin (Choice B) is not appropriate without assessing the blood glucose first. Monitoring for signs of hyperglycemia (Choice D) is not the immediate concern in this situation.

2. Alcohol, caffeine, or drugs are high-risk factors that all fall under which broad classification of risk factors?

• A. Social demographic
• B. Environmental
• C. Biophysical
• D. Psychosocial

Correct answer: D

Rationale: The correct answer is D: Psychosocial. Alcohol, caffeine, or drug use are considered psychosocial risk factors as they are related to individual behavior, lifestyle choices, and social interactions. Choices A, B, and C are incorrect. Social demographic factors (choice A) refer to characteristics of a population such as age, gender, education, income, etc. Environmental factors (choice B) include physical surroundings like air quality, housing conditions, etc. Biophysical factors (choice C) involve biological aspects like genetics, physiology, and health conditions.

3. A client has a new diagnosis of chlamydia. Which of the following actions should the nurse take?

• A. Report the infection to the local health department
• B. Apply an antiviral cream to lesions
• C. Instruct the client to use condoms until the treatment is completed
• D. Initiate contact precautions

Correct answer: A

Rationale: The correct answer is to report the infection to the local health department. Chlamydia is a reportable disease, meaning healthcare providers are required to report cases to public health authorities for tracking and control measures. Choice B is incorrect because chlamydia is a bacterial infection, not a viral infection, so antiviral cream would not be effective. Choice C is important advice for preventing the spread of chlamydia but is not the priority in this scenario. Choice D is not necessary for chlamydia, as it is primarily transmitted through sexual contact.

4. What are the fine, down-like hairs on the newborn's ears, shoulders, lower back, and/or forehead known as?

• A. Vernix.
• B. Lanugo.
• C. Milia.
• D. Vibrissae.

Correct answer: B

Rationale: Lanugo is the term used to describe the fine, down-like hairs found on a newborn's ears, shoulders, lower back, and/or forehead. These hairs are different from vernix, which is a waxy or cheese-like white substance covering the skin of newborns. Milia are small, white, or yellowish cysts that commonly appear on a newborn's face, while vibrissae are the thick, stiff hairs commonly found around the nose and other parts of the face.

5. A client diagnosed with type 1 diabetes receives insulin. He asks the nurse why he can't just take pills instead. What is the best response by the nurse?

• A. Insulin must be injected because it needs to work quickly.
• B. Insulin can't be in a pill because it is destroyed in stomach acid.
• C. Have you talked to your doctor about taking pills instead?
• D. I know it is tough, but you will get used to the shots soon.

Correct answer: B

Rationale: The correct answer is B because insulin cannot be taken orally as it gets destroyed by stomach acid. Choice A is incorrect as the speed of action is not the reason why insulin can't be in pill form. Choice C is incorrect as it doesn't address the nature of insulin. Choice D is incorrect as it doesn't provide a factual reason why insulin can't be in pill form.

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