Nursing Elites

1. When reinforcing teaching and instructing the patient, which basic principle of teaching should you follow?

• A. Sequence the instruction from the least complex to the most complex.
• B. Assume that the patient knows little or nothing about the topic.
• C. Tell the patient to call their significant other so you can instruct them.
• D. Use medically oriented terms so the patient will be able to speak with the doctor.

Correct answer: A

Rationale: The correct principle of teaching to follow when reinforcing teaching and instructing the patient is to sequence the instruction from the least complex to the most complex. This approach facilitates learning by building upon simpler concepts before moving to more advanced ones. Choice B is incorrect because assuming the patient knows little or nothing about the topic may not always be accurate and can be patronizing. Choice C is incorrect as it does not focus on the direct teaching approach to the patient. Choice D is incorrect as using medically oriented terms may confuse the patient rather than facilitate understanding.

2. A clinical instructor teaches a class for the public about diabetes mellitus. Which individual does the nurse assess as being at highest risk for developing diabetes?

• A. The 50-year-old client who does not engage in any physical exercise
• B. The 56-year-old client who drinks three glasses of wine daily
• C. The 42-year-old client who is 50 pounds overweight
• D. The 38-year-old client who smokes one pack of cigarettes daily

Correct answer: C

Rationale: The 42-year-old client who is 50 pounds overweight is at the highest risk for developing diabetes. Excess weight is a significant risk factor for diabetes as it can lead to insulin resistance and metabolic abnormalities. Choices A, B, and D are also risk factors for diabetes, but being overweight has a stronger association with the development of the condition compared to lack of exercise, excessive alcohol consumption, or smoking.

3. 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.

4. Which atrioventricular heart block is also referred to as Mobitz II?

• A. Third-degree atrioventricular heart block
• B. Second-degree atrioventricular heart block
• C. First-degree atrioventricular heart block
• D. Complete heart block

Correct answer: B

Rationale: The correct answer is B. Second-degree atrioventricular heart block is also known as Mobitz II. In Mobitz II, some atrial impulses are blocked from reaching the ventricles, resulting in occasional dropped beats. Third-degree atrioventricular heart block is known as complete heart block, where no atrial impulses reach the ventricles. First-degree atrioventricular heart block is a condition where there is delayed conduction between the atria and ventricles but all atrial impulses are eventually conducted to the ventricles.

5. Which of the following is considered an internal disaster?

• A. A patient fall
• B. The massive spread of pneumonia
• C. A computer hacking episode
• D. Unexpected staff absences due to illness

Correct answer: C

Rationale: A computer hacking episode is considered an internal disaster as it disrupts the internal operations of the healthcare facility, compromising data security and potentially impacting patient care. Choices A, B, and D do not directly relate to internal disasters in a healthcare setting. A patient fall is a patient safety issue, the massive spread of pneumonia is a public health concern, and unexpected staff absences due to illness may affect staffing levels but are not typically classified as internal disasters.

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