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1. A 32-year-old patient with diabetes is starting on intensive insulin therapy. Which type of insulin will the nurse discuss using for mealtime coverage?
- A. Lispro (Humalog)
- B. Glargine (Lantus)
- C. Detemir (Levemir)
- D. NPH (Humulin N)
Correct answer: A
Rationale: For mealtime coverage in intensive insulin therapy, rapid-acting insulins like Lispro (Humalog) are used. Lispro has a quick onset of action, making it suitable for covering the rise in blood sugar levels after meals. Glargine (Lantus), Detemir (Levemir), and NPH (Humulin N) are all long-acting insulins and are not appropriate for mealtime coverage as they do not act quickly enough to manage postprandial glucose spikes.
2. Lippitt's phases of change are important factors in the change process. The phase that involves key people in data collection is known as:
- A. Assess the motivation.
- B. Choose a change agent.
- C. Diagnose the problem.
- D. Maintain the change.
Correct answer: C
Rationale: The correct answer is C: 'Diagnose the problem.' In Lippitt's phases of change, the first step is to diagnose the problem, which involves key people in data collection and problem-solving. This step is crucial as it helps identify the root causes of the issues that need to be addressed. Assessing the motivation (A) comes later in the change process once the problem has been diagnosed. Choosing a change agent (B) and maintaining the change (D) are also important steps in the change process but do not specifically involve key people in data collection as in the diagnosis phase.
3. Which level in Maslow's hierarchy is rarely met?
- A. Esteem
- B. Safety
- C. Self-actualization
- D. Belongingness
Correct answer: C
Rationale: The correct answer is C, 'Self-actualization.' Self-actualization, the highest level in Maslow's hierarchy, involves developing one's full potential and achieving personal growth. It is considered rarely met because it requires a deep understanding of oneself, a strong sense of purpose, and the ability to pursue intrinsic goals. Esteem (choice A) focuses on respect, recognition, and self-esteem, which are more commonly achieved than self-actualization. Safety (choice B) and belongingness (choice D) are also more commonly attained as they relate to basic needs for security and social connections, which are essential for overall well-being.
4. A healthcare professional is administering 1 L of 0.9% sodium chloride to a client who is postoperative and has fluid volume deficit. Which of the following changes should the healthcare professional identify as an indication that the treatment was successful?
- A. Increase in hematocrit
- B. Increase in respiratory rate
- C. Decrease in heart rate
- D. Decrease in capillary refill time
Correct answer: D
Rationale: The correct answer is D: Decrease in capillary refill time. In a client with fluid volume deficit, improving capillary refill time indicates that the perfusion status is improving due to the increase in fluid volume. Choices A, B, and C are incorrect. An increase in hematocrit may indicate hemoconcentration due to fluid loss, an increase in respiratory rate may suggest respiratory distress, and a decrease in heart rate may not be directly related to fluid volume status.
5.
- A. The patient administers the glargine 30 minutes before each meal
- B.
- C. The patient draws up the regular insulin and then the glargine in the same syringe.
- D. The patient disposes of the open vials of glargine and regular insulin after 4 weeks
Correct answer: D
Rationale:
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