Nursing Elites

1. A client is prescribed insulin glargine. Which of the following should the nurse instruct the client to do regarding administration of this medication?

• A. Inject insulin glargine 30 minutes before a meal.
• B. Shake the insulin vial before administration.
• C. Administer insulin glargine once daily at bedtime.
• D. Take insulin glargine with short-acting insulin.

Correct answer: C

Rationale: The correct answer is C: Administer insulin glargine once daily at bedtime. Insulin glargine is a long-acting insulin that provides a basal level of insulin throughout the day. It should be given at the same time each day, usually at bedtime, to maintain a consistent blood sugar level. Choices A, B, and D are incorrect. Injecting insulin glargine before a meal (Choice A) is not necessary as it is a long-acting insulin. Shaking the insulin vial (Choice B) is not recommended as it may cause bubbles to form, affecting the accuracy of the dose. Taking insulin glargine with short-acting insulin (Choice D) is not a typical practice as insulin glargine is used for basal insulin coverage.

2. A nurse is providing dietary teaching for a client who has chronic cholecystitis. Which of the following diets should the nurse recommend?

• A. Low potassium diet
• B. High fiber diet
• C. Low fat diet
• D. Low sodium diet

Correct answer: C

Rationale: The correct answer is C: 'Low fat diet.' A client with chronic cholecystitis should follow a low-fat diet to decrease the frequency of biliary colic episodes. Fats can trigger the release of cholecystokinin, which stimulates the gallbladder to contract, potentially causing pain in individuals with cholecystitis. Choices A, B, and D are incorrect. A low potassium diet is prescribed for individuals with specific kidney conditions or on certain medications. A high fiber diet is beneficial for conditions like constipation, diverticulosis, or to promote general bowel health. A low sodium diet is often recommended for conditions like hypertension or heart failure to reduce fluid retention.

3. A nurse in a provider's office is assessing the motor skill development of a 15-month-old toddler during a well-child visit. What gross motor skills should the nurse expect to observe?

• A. Walks without assistance using a wide stance
• B. Climbs stairs with assistance
• C. Runs smoothly
• D. Kicks a ball forward

Correct answer: A

Rationale: The correct answer is A. At 15 months, toddlers typically walk independently but may do so with a wide stance for balance. Choice B, climbing stairs with assistance, is more common around 18 months. Choice C, running smoothly, is usually achieved around 2 years of age. Choice D, kicking a ball forward, generally develops around 2 to 3 years of age. Therefore, for a 15-month-old toddler, the nurse should expect the child to walk without assistance using a wide stance for balance.

4. When teaching a client about the use of trazodone, what should be included?

• A. It can cause sedation
• B. It is a stimulant
• C. It has no side effects
• D. It should be taken with food

Correct answer: A

Rationale: The correct answer is A. Trazodone can cause sedation, so clients should be cautioned about activities requiring alertness, like driving. Choice B is incorrect because trazodone is not a stimulant; it is actually a sedating antidepressant. Choice C is incorrect as all medications have potential side effects. Choice D is not specifically indicated for trazodone; the client should follow the prescribing healthcare provider's instructions regarding food intake.

5. A nurse is assessing a client with chronic kidney disease. Which of the following findings should the nurse monitor?

• A. Hypokalemia
• B. Fluid overload
• C. Decreased blood pressure
• D. Increased appetite

Correct answer: B

Rationale: The correct answer is B: Fluid overload. Clients with chronic kidney disease are prone to fluid overload due to impaired kidney function. The kidneys may not effectively regulate fluid balance, leading to fluid retention. Monitoring for signs of fluid overload, such as edema, hypertension, and shortness of breath, is crucial. Choice A, Hypokalemia, is less likely in chronic kidney disease as the kidneys often have difficulty excreting potassium, leading to hyperkalemia. Decreased blood pressure (Choice C) is not a common finding in chronic kidney disease unless complications like volume depletion occur. Increased appetite (Choice D) is not typically associated with chronic kidney disease; in fact, many clients may experience a decreased appetite due to various factors such as uremia and dietary restrictions.

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