Nursing Elites

1. A client diagnosed with type 1 diabetes receives insulin. He asks the nurse why he can't just take pills instead. What is the best response by the nurse?

• A. Insulin must be injected because it needs to work quickly.
• B. Insulin can't be in a pill because it is destroyed in stomach acid.
• C. Have you talked to your doctor about taking pills instead?
• D. I know it is tough, but you will get used to the shots soon.

Correct answer: B

Rationale: The correct answer is B because insulin cannot be taken orally as it gets destroyed by stomach acid. Choice A is incorrect as the speed of action is not the reason why insulin can't be in pill form. Choice C is incorrect as it doesn't address the nature of insulin. Choice D is incorrect as it doesn't provide a factual reason why insulin can't be in pill form.

2. Your patient has been diagnosed with orchiditis. What information about this disorder should you inform the patient about?

• A. This disorder often occurs as a result of streptococcus.
• B. This disorder can be symptomatically treated with ice.
• C. This disorder can be symptomatically treated with heat.
• D. This disorder is typically treated with surgery.

Correct answer: B

Rationale: Orchiditis can be symptomatically treated with ice to reduce inflammation. Choice A is incorrect because orchiditis is not typically caused by streptococcus. Choice C is incorrect as heat is not the recommended treatment for orchiditis. Choice D is also incorrect as surgery is not the first-line treatment for orchiditis.

3. What is the main objective of palliative care?

• A. To cure the disease
• B. To provide relief from symptoms and improve quality of life
• C. To extend hospital stays
• D. To focus solely on treatment

Correct answer: B

Rationale: The main objective of palliative care is to provide relief from symptoms and improve quality of life. Palliative care focuses on enhancing the quality of life for patients facing serious illnesses by providing relief from symptoms such as pain, stress, and other physical and emotional issues. Choice A is incorrect because palliative care does not aim to cure the disease but rather to manage symptoms. Choice C is incorrect as the goal of palliative care is not to extend hospital stays unnecessarily but to improve the patient's well-being. Choice D is incorrect as palliative care is not solely focused on treatment but takes a holistic approach to care that includes addressing physical, emotional, social, and spiritual needs.

4. A client with DM has an above-knee amputation because of severe peripheral vascular disease. Two days following surgery, when preparing the client for dinner, what is the nurse's primary responsibility?

• A. Check the client's serum glucose level
• B. Assist the client out of bed to the chair
• C. Place the client in a high-Fowler's position
• D. Ensure that the client's residual limb is elevated

Correct answer: A

Rationale: The correct answer is to check the client's serum glucose level. In a client with diabetes who just had surgery, monitoring the serum glucose level is crucial to ensure proper management of the condition. This helps in preventing complications related to blood sugar fluctuations. Assisting the client out of bed may be important but not the primary responsibility at this time. Placing the client in a high-Fowler's position or ensuring the residual limb is elevated are important interventions for comfort and circulation but are not the primary concern in this scenario.

5. 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.

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