Nursing Elites

1. A 48-year-old male patient screened for diabetes at a clinic has a fasting plasma glucose level of 120 mg/dL (6.7 mmol/L). The nurse will plan to teach the patient about

• A. self-monitoring of blood glucose
• B. using low doses of regular insulin
• C. lifestyle changes to lower blood glucose
• D. effects of oral hypoglycemic medications

Correct answer: C

Rationale: When a patient has a fasting plasma glucose level of 120 mg/dL (6.7 mmol/L), indicating prediabetes, the initial approach is focused on lifestyle modifications to lower blood glucose levels. These changes may include dietary adjustments, increased physical activity, and weight management. Self-monitoring of blood glucose, insulin therapy, and oral hypoglycemic medications are not typically the first-line interventions for patients with prediabetes. Educating the patient about lifestyle changes to lower blood glucose is the most appropriate action at this stage.

2. What is the main focus of health literacy initiatives?

• A. To promote the use of medical jargon
• B. To improve patient communication skills
• C. To ensure that patients understand their health information
• D. To reduce the use of electronic health records

Correct answer: C

Rationale: The main focus of health literacy initiatives is to ensure that patients understand their health information. By improving patient comprehension, individuals can make informed decisions about their health, leading to better health outcomes. Promoting the use of medical jargon would have the opposite effect, making health information less accessible. Improving patient communication skills is important but not the primary focus of health literacy initiatives. Electronic health records are tools for managing health information and not directly related to the main goal of health literacy initiatives.

3. One of the critical elements in interviewing is:

• A. Time management during the interview.
• B. Involving others in the interview process.
• C. Choosing the interview location.
• D. Developing an interview guide.

Correct answer: D

Rationale: Developing an interview guide is a critical element in interviewing as it allows for a systematic approach. An interview guide helps the interviewer stay on track, ensures important topics are covered, and provides consistency in questioning. Options A, B, and C are not as crucial as developing an interview guide. Time management during the interview is important but not the critical element being addressed in this question. Involving others may be beneficial in some cases, but it is not a fundamental element of interviewing. While choosing a suitable interview location is essential for a conducive environment, it is not as central as having a structured interview guide.

4. The nurse identifies a need for additional teaching when the patient who is self-monitoring blood glucose

• A. washes the puncture site using warm water and soap
• B. chooses a puncture site in the center of the finger pad
• C. hangs the arm down for a minute before puncturing the site
• D. says the result of 120 mg indicates good blood sugar control

Correct answer: B

Rationale: The correct answer is B because choosing a puncture site in the center of the finger pad is not recommended for blood glucose monitoring. The recommended sites are the sides of the fingertips. Option A is correct as washing the puncture site using warm water and soap is a good practice. Option C is also correct as hanging the arm down for a minute can help increase blood flow. Option D is incorrect as a blood sugar level of 120 mg/dL may not necessarily indicate good blood sugar control and needs further interpretation.

5. In order to assist an older diabetic patient to engage in moderate daily exercise, which action is most important for the nurse to take?

• A. Determine what type of activities the patient enjoys.
• B. Remind the patient that exercise will improve self-esteem.
• C. Teach the patient about the effects of exercise on glucose levels.
• D. Give the patient a list of activities that are moderate in intensity.

Correct answer: A

Rationale: The correct answer is to determine what type of activities the patient enjoys. This approach is crucial as it helps in personalizing the exercise plan to the patient's preferences, making it more likely for them to adhere to it. Choice B is incorrect because focusing on self-esteem may not directly motivate the patient to engage in exercise. Choice C, although important, may not be the initial step as understanding the patient's preferences comes first. Choice D limits the patient's autonomy by not involving them in the decision-making process.

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