Nursing Elites

1. A client who is postoperative is verbalizing pain as a 2 on a pain scale of 0 to 10. Which of the following statements should the nurse identify as an indication that the client understands the preoperative teaching they received about pain management?

• A. ''I think I should take my pain medication more often, since it is not controlling my pain.''
• B. ''Breathing faster will help me keep my mind off of the pain.''
• C. ''It might help me to listen to music while I'm lying in bed.''
• D. ''I don't want to walk today because I have some pain.''

Correct answer: D

Rationale: The correct answer is D because the client is demonstrating an understanding of the preoperative teaching by acknowledging the pain and relating it to the need to rest. Walking may exacerbate the pain, and the client's decision not to walk shows an awareness of their body's signals. Choices A, B, and C are incorrect as they do not reflect a good understanding of pain management. Choice A suggests self-medicating without consulting healthcare providers, choice B focuses on distraction rather than addressing the pain, and choice C offers a coping mechanism but does not address the pain directly.

2. The healthcare provider suspects the Somogyi effect in a 50-year-old patient whose 6:00 AM blood glucose is 230 mg/dL. Which action will the nurse teach the patient to take?

• A. Avoid snacking at bedtime.
• B. Increase the rapid-acting insulin dose.
• C. Check the blood glucose during the night.
• D. Administer a larger dose of long-acting insulin.

Correct answer: C

Rationale: The Somogyi effect, also known as rebound hyperglycemia, occurs due to an excessive insulin dose at night, leading to hypoglycemia in the early morning hours. To address this, the nurse should instruct the patient to check their blood glucose during the night to determine if hypoglycemia is present, which triggers the rebound hyperglycemia. By monitoring blood glucose levels during the night, the patient can identify if adjustments are needed to prevent this phenomenon and maintain stable glucose levels. Choices A, B, and D are incorrect. Avoiding snacking at bedtime, increasing rapid-acting insulin dose, or administering a larger dose of long-acting insulin are not appropriate actions to manage the Somogyi effect. Checking blood glucose during the night is crucial to identify and prevent the rebound hyperglycemia characteristic of this phenomenon.

3. Which of the following is one important factor in sustaining employee satisfaction?

• A. Organization culture
• B. Individual performance
• C. Performance evaluation
• D. Job satisfaction

Correct answer: D

Rationale: Job satisfaction is a crucial factor in sustaining employee satisfaction. Studies have shown that higher levels of job satisfaction lead to lower turnover rates and higher productivity. Choice A, organization culture, is important but focuses more on the overall environment rather than individual satisfaction. Choice B, individual performance, is relevant but doesn't directly address employee satisfaction. Choice C, performance evaluation, is a process rather than a factor in sustaining satisfaction.

4. What is the role of the Joint Commission in healthcare?

• A. Advocacy for patients
• B. Setting standards for patient care
• C. Providing direct patient care
• D. Approving healthcare facilities

Correct answer: D

Rationale: The correct answer is D: 'Approving healthcare facilities.' The Joint Commission's primary role is to accredit and certify healthcare organizations and programs in the United States. This accreditation ensures that healthcare facilities meet specific quality and safety standards. Choices A, B, and C are incorrect because the Joint Commission focuses on evaluating and accrediting healthcare facilities rather than advocating for patients, providing direct care, or setting standards for patient care.

5. Which of the following is an example of a primary prevention strategy in public health?

• A. Screening for diabetes
• B. Vaccination programs
• C. Emergency response planning
• D. Chronic disease management

Correct answer: B

Rationale: The correct answer is B. Vaccination programs are considered a primary prevention strategy in public health because they aim to prevent the occurrence of diseases before they occur. Screening for diabetes (choice A) is more of a secondary prevention strategy that aims to detect and treat the disease early. Emergency response planning (choice C) is more focused on preparedness and response rather than preventing the initial occurrence of health issues. Chronic disease management (choice D) involves treating and controlling diseases that have already developed, making it a tertiary prevention strategy rather than primary.

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