Nursing Elites

1. You are working on a pediatric unit. Which toy or other diversional item or activity is most appropriate for your 18-month-old patient?

• A. Story books
• B. Beach balls
• C. An interactive play session with other children less than 2 years of age
• D. Pickup sticks

Correct answer: B

Rationale: A beach ball is appropriate for an 18-month-old as it is safe and can help with motor skills development. Choice A, storybooks, may not be suitable for this age group due to limited attention span. Choice C involves interaction with other children which may not always be feasible in a healthcare setting. Choice D, pickup sticks, poses a choking hazard and is not suitable for toddlers.

2. Which of the following foods enhances the absorption of an iron supplement?

• A. Orange juice
• B. Green beans
• C. Fortified milk
• D. Baked potato

Correct answer: A

Rationale: The correct answer is Orange juice. Orange juice enhances the absorption of an iron supplement due to its high vitamin C content. Vitamin C helps in the absorption of non-heme iron, the type of iron found in plant-based foods and iron supplements. Green beans, fortified milk, and baked potato do not have the same level of vitamin C as orange juice, making them less effective in enhancing iron absorption.

3. A client with type 1 DM has a finger stick glucose level of 258mg/dl at bedtime. An order for sliding scale insulin exists. The nurse should:

• A. Call the physician
• B. Encourage the intake of fluids
• C. Administer the insulin as ordered
• D. Give the client ½ cup of orange juice

Correct answer: C

Rationale: In this scenario, the client with type 1 DM has a high glucose level at bedtime. The appropriate action for the nurse is to administer the sliding scale insulin as ordered. This insulin regimen is specifically designed to manage high blood glucose levels. Calling the physician is not necessary as the protocol for sliding scale insulin is already in place. Encouraging fluid intake or providing orange juice is not the correct intervention for addressing high blood glucose levels in this case.

4. A nurse is preparing to discharge a client who has end-stage heart failure. The client's partner tells the nurse she can no longer handle caring for the client. Which of the following actions should the nurse take?

• A. Request another family member to assist the client's partner with care
• B. Recommend the partner to place the client in a long-term care facility
• C. Contact the case manager to discuss discharge options
• D. Ask the provider to delay the client's discharge home for a few more days

Correct answer: C

Rationale: The nurse should contact the case manager to discuss discharge options and support the client's partner. This action is appropriate as it involves seeking professional guidance and support for the client's partner who is struggling to care for the client. Option A is not the best choice as it solely focuses on involving another family member without addressing the partner's concerns directly. Option B is premature as recommending long-term care should be a well-considered decision involving multiple healthcare professionals. Option D delays the inevitable without providing a solution to the partner's current challenges.

5. Which of the following chronic complications is associated with diabetes?

• A. Dizziness, dyspnea on exertion, and coronary artery disease.
• B. Retinopathy, neuropathy, and coronary artery disease.
• C. Leg ulcers, cerebral ischemic events, and pulmonary infarcts.
• D. Fatigue, nausea, vomiting, muscle weakness, and cardiac arrhythmias.

Correct answer: B

Rationale: The correct answer is B. Diabetes is associated with chronic complications such as retinopathy, neuropathy, and coronary artery disease. Choice A includes symptoms rather than chronic complications of diabetes. Choice C lists conditions not typically associated with diabetes. Choice D describes symptoms that may occur in various medical conditions but are not specific chronic complications of diabetes.

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