Nursing Elites

1. Your client has a doctor's order that reads 'advance diet as tolerated'. This client has returned from the recovery room after an appendectomy and he states, 'I am hungry'. What would you offer this client to consume?

• A. Cheese and crackers
• B. Apple sauce
• C. Chicken broth
• D. A peanut butter sandwich

Correct answer: C

Rationale: Chicken broth is a suitable option for a post-appendectomy patient beginning to tolerate oral intake. It is clear liquid and easily digestible, making it a gentle choice for someone who has just returned from surgery. Cheese and crackers, apple sauce, and a peanut butter sandwich are not ideal options for an individual who needs to start with a light and easily digestible diet.

2. Clients with type 1 diabetes may require which of the following changes to their daily routine during periods of infection?

• A. No change
• B. Less insulin
• C. More insulin
• D. Oral antidiabetic agents

Correct answer: C

Rationale: During periods of infection, clients with type 1 diabetes may require more insulin to manage the increased blood glucose levels caused by stress and illness. Insulin needs often rise during infections due to the body's increased resistance to the effects of insulin. Therefore, increasing insulin doses is crucial to maintain blood glucose control. Choices A, B, and D are incorrect. Option A ('No change') is inaccurate because during infections, insulin requirements typically increase. Option B ('Less insulin') is incorrect as the body's increased insulin resistance during infections usually necessitates higher insulin doses. Option D ('Oral antidiabetic agents') is not suitable for type 1 diabetes management as these medications are primarily used for type 2 diabetes.

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 enters the hallway and discovers a visitor looking at a client's medical information on a computer. Which of the following actions should the nurse take first?

• A. Inform the care nurse that a visitor viewed a client's protected health information.
• B. Close the documentation program on the computer.
• C. Inform the visitor that the client's records are confidential.
• D. Find out which staff member left the documentation program on the screen.

Correct answer: B

Rationale: The correct first action for the nurse to take is to close the documentation program on the computer to prevent further unauthorized access to the client's medical information. Choice A is incorrect because the immediate concern is to secure the information first. Choice C, while important, can be addressed after securing the information. Choice D, finding out which staff member left the program open, is not the immediate priority when patient confidentiality is at risk.

5. To resolve a conflict between staff members regarding potential changes in policy, a nurse manager decides to implement the changes she prefers regardless of the feelings of those who oppose those changes. Which of the following conflict-resolution strategies is the nurse manager using?

• A. Competing
• B. Collaborating
• C. Compromising
• D. Cooperating

Correct answer: A

Rationale: The nurse manager is utilizing the competing conflict-resolution strategy. Competing involves making decisions based on one's preferences without considering the opinions or feelings of others. In this scenario, the nurse manager is unilaterally implementing changes despite opposition, demonstrating a competitive approach. Collaborating involves working together to find a mutually beneficial solution, compromising involves finding a middle ground acceptable to both parties, and cooperating involves working together towards a shared goal. These options are not applicable in this situation as the nurse manager is imposing her preferred changes without regard for others' input.

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