Nursing Elites

1. Which of the following would be the best strategy for the nurse to use when teaching insulin injection techniques to a newly diagnosed client with diabetes?

• A. Provide written pre and post tests
• B. Ask questions during practice
• C. Allow another diabetic to assist
• D. Observe a return demonstration

Correct answer: D

Rationale: The best strategy for the nurse to use when teaching insulin injection techniques to a newly diagnosed client with diabetes is to observe a return demonstration. This method ensures that the client can correctly perform the technique. Providing written pre and post tests (choice A) may assess knowledge but not application. Asking questions during practice (choice B) may help with understanding but not necessarily with the actual performance. Allowing another diabetic to assist (choice C) may provide peer support but does not guarantee correct technique demonstration.

2. A client has developed thrombophlebitis of the left leg. Which nursing intervention should be given the highest priority?

• A. Elevate leg on 2 pillows
• B. Apply support stockings
• C. Apply warm compresses
• D. Maintain complete bed rest

Correct answer: A

Rationale: The highest priority nursing intervention for a client with thrombophlebitis of the left leg is to elevate the leg on 2 pillows. Elevating the leg helps reduce swelling and pain associated with thrombophlebitis by promoting venous return. Applying support stockings (choice B) can be beneficial but is not the highest priority as elevation is more effective in the acute phase. Applying warm compresses (choice C) may worsen the condition by dilating the blood vessels, leading to increased pain and swelling. Maintaining complete bed rest (choice D) is important, but elevation takes precedence to improve circulation and reduce the risk of complications.

3. A nurse working in a community health setting is performing primary health screenings. Which individual is at highest risk for contracting an HIV infection?

• A. A 17-year-old who is sexually active with numerous partners.
• B. A 45-year-old lesbian who has been sexually active with two partners in the past year.
• C. A 30-year-old cocaine user who inhales the drug and works in a topless bar.
• D. A 34-year-old male homosexual who is in a monogamous relationship.

Correct answer: A

Rationale: The correct answer is A. A 17-year-old who is sexually active with numerous partners is at the highest risk for contracting an HIV infection due to engaging in risky sexual behavior with multiple partners, increasing the likelihood of exposure to the virus. Choice B is less risky as the individual has had a relatively lower number of sexual partners in the past year. Choice C, although involving drug use, does not directly correlate with a higher risk of contracting HIV unless needles are shared. Choice D, a 34-year-old male homosexual in a monogamous relationship, has a lower risk compared to choice A as long as the relationship remains monogamous.

4. While assessing a client in an outpatient facility with a panic disorder, the nurse completes a thorough health history and physical exam. Which finding is most significant for this client?

• A. Compulsive behavior
• B. Sense of impending doom
• C. Fear of flying
• D. Predictable episodes

Correct answer: B

Rationale: The correct answer is B: 'Sense of impending doom.' In panic disorder, a sense of impending doom is a hallmark symptom often experienced by clients. This intense feeling of dread or fear is a key feature of panic attacks. Compulsive behavior (choice A) may be more indicative of obsessive-compulsive disorder rather than panic disorder. Fear of flying (choice C) may be more related to specific phobias rather than panic disorder. Predictable episodes (choice D) do not align with the unpredictable nature of panic attacks.

5. Which one of the following statements, if made by the client, indicates teaching about Inderal (propranolol) has been effective?

• A. ''I may experience seizures if I stop the medication abruptly.''
• B. ''I may experience an increase in my heart rate for a few weeks.''
• C. ''I can expect to feel nervousness the first few weeks.''
• D. ''I can have a heart attack if I stop this medication suddenly.''

Correct answer: D

Rationale: The correct answer is D. Stopping Inderal (propranolol) abruptly can cause rebound hypertension, angina, and even a myocardial infarction (heart attack), so it is crucial to taper off the medication under medical supervision. Choices A, B, and C are incorrect because they do not reflect the serious consequences associated with abrupt discontinuation of propranolol.

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