Nursing Elites

1. A 28-year-old male patient with type 1 diabetes reports how he manages his exercise and glucose control. Which behavior indicates that the nurse should implement additional teaching?

• A. The patient always carries hard candies when engaging in exercise.
• B. The patient goes for a vigorous walk when his glucose is 200 mg/dL.
• C. The patient has a peanut butter sandwich before going for a bicycle ride.
• D. The patient increases daily exercise when ketones are present in the urine.

Correct answer: D

Rationale: The correct answer is D because increasing exercise when ketones are present in the urine is inappropriate and potentially dangerous for a patient with type 1 diabetes. This behavior can worsen the ketosis and lead to further complications. Choices A, B, and C demonstrate appropriate self-management strategies for a patient with type 1 diabetes. Carrying hard candies during exercise can help prevent hypoglycemia, going for a walk with a glucose level of 200 mg/dL can help lower blood sugar, and having a snack before physical activity can provide necessary energy.

2. A nurse is caring for a client who has an indwelling urinary catheter. Which of the following findings indicates that the catheter requires irrigation?

• A. Urine is positive for ketones
• B. Urine has an unusual odor
• C. Urine specific gravity is 1.035 (normal range: 1.010 to 1.025)
• D. Bladder scan shows 525 mL of urine

Correct answer: A

Rationale: The correct answer is A. Ketones in the urine may indicate infection or blockage in the urinary catheter, necessitating irrigation to ensure proper drainage. Choice B, an unusual odor in the urine, may suggest infection but does not directly indicate the need for catheter irrigation. Choice C, a high urine specific gravity, is indicative of concentrated urine but does not specifically point to the need for catheter irrigation. Choice D, a bladder scan showing 525 mL of urine, indicates urine retention, which may require catheterization or further assessment but not necessarily irrigation.

3. Which of the following should be included in a discussion of advance directives with new nurse graduates?

• A. According to the Patient Self-Determination Act, nurses are required to inform clients of their right to create an advance directive.
• B. The advance directive designates an individual who will make financial decisions for the client if he or she is unable to do so.
• C. A living will designates who will make health-care decisions for an individual in the event the individual is unable or incompetent to make his or her own decisions.
• D. The advance directive designates a health-care surrogate who will make known the client�s wishes regarding medical treatment if the client is unable to do so.

Correct answer: D

Rationale: One function of the advance directive is to appoint a health-care surrogate who will make known the client�s wishes for medical treatment to the medical and nursing team if the client is unable to do so.

4. The nurse is preparing to teach a 43-year-old man who is newly diagnosed with type 2 diabetes about home management of the disease. Which action should the nurse take first?

• A. Ask the patient�s family to participate in the diabetes education program.
• B. Assess the patient�s perception of what it means to have diabetes mellitus.
• C. Demonstrate how to check glucose using capillary blood glucose monitoring.
• D. Discuss the need for the patient to actively participate in diabetes management.

Correct answer: B

Rationale:

5. Which of the following are considered part of the operating expenses within health care organizations? (EXCEPT)

• A. Maintenance costs
• B. Rental fees
• C. Renovation costs
• D. Supplies

Correct answer: C

Rationale: Operating expenses in health care organizations typically include costs like maintenance, rental fees, and supplies as they are necessary for the day-to-day operations. Renovation costs, on the other hand, are considered capital expenses as they involve significant improvements to facilities rather than routine operational expenses. Therefore, the correct answer is C. Choices A, B, and D are part of operating expenses in health care organizations because they directly contribute to the ongoing operational needs.

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