Nursing Elites

1. Which teaching point should the nurse include when providing education to an adolescent client who participates in soccer regarding the plan of care for diabetes mellitus?

• A. Decreased food intake
• B. Increased doses of insulin
• C. Increased food intake
• D. Decreased doses of insulin

Correct answer: C

Rationale: The correct teaching point the nurse should include is to advise the adolescent client who participates in soccer to increase food intake. Physical activity increases glucose utilization, so adolescents with diabetes need to consume additional carbohydrates to prevent hypoglycemia during and after exercise. Choice A (Decreased food intake) is incorrect because the adolescent needs extra carbohydrates to support the increased physical activity. Choice B (Increased doses of insulin) is incorrect as the focus should be on adjusting food intake rather than insulin doses. Choice D (Decreased doses of insulin) is also incorrect as the insulin doses should be adjusted based on the increased food intake and physical activity level.

2. A parent brings their 2-year-old son in for a well visit. The nurse assesses his growth since the last appointment. Which finding should concern the nurse?

• A. Prominent abdomen
• B. Forward curve of the spine in the sacral area
• C. Increase in height of 5 inches in the past year
• D. Total weight gain of 15 lb in the past year

Correct answer: D

Rationale: The correct answer is D. A total weight gain of 15 lb in one year for a 2-year-old is excessive and may indicate an underlying issue such as a metabolic disorder or overfeeding. This rapid weight gain can put the child at risk for health problems. Choices A, B, and C are not typically concerning findings in a 2-year-old. A prominent abdomen can be normal at this age due to a toddler's slightly protruding belly, a forward curve of the spine at the sacral area is a typical finding in young children, and an increase in height of 5 inches in a year is within the expected range of growth for a 2-year-old.

3. A teen with asthma asks the nurse why it is hard to breathe during an asthma attack. The nurse explains that exposure to a “trigger” results in which of these manifestations?

• A. Bronchodilation, muscle relaxation, and decreased mucus production
• B. Air trapping and hypo-inflation of the alveoli
• C. Air trapping and decreased blood flow to the upper airway
• D. Bronchoconstriction, airway inflammation, and excess mucus production

Correct answer: D

Rationale: The correct answer is D. Asthma triggers cause bronchoconstriction, airway inflammation, and increased mucus production, leading to difficulty breathing. This combination of manifestations results in narrowing of the airways, making it hard for the individual to breathe effectively. Choices A, B, and C are incorrect because during an asthma attack, bronchodilation, muscle relaxation, and decreased mucus production do not occur. Instead, the airways constrict, become inflamed, and produce excess mucus, contributing to the breathing difficulties experienced by individuals with asthma.

4. A child has a nasogastric (NG) tube after surgery for Hirschsprung disease. What is the purpose of the NG tube?

• A. Prevent the spread of infection.
• B. Monitor electrolyte balance.
• C. Prevent abdominal distention.
• D. Maintain accurate records of output.

Correct answer: C

Rationale: The primary purpose of an NG tube post-surgery for Hirschsprung disease is to prevent abdominal distention by decompressing the stomach and intestines. This helps prevent complications and promotes healing.

5. The nurse manager is compiling a report for a hospital committee on the quality of nursing-sensitive indicators for a nursing unit. Which does the nurse manager include in the report?

• A. The average age of the nurses on the unit
• B. The salary ranges for the nurses on the unit
• C. The education and certification of the nurses on the unit
• D. The number of nurses who have applied but were not hired for the unit

Correct answer: C

Rationale: The education and certification of nurses are key nursing-sensitive indicators that reflect the quality of care provided on the unit.

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