Nursing Elites

1. A client with diabetes experiences Somogyi's effect. To prevent this complication, the nurse should instruct the client to:

• A. Take insulin at 2:00 PM each day
• B. Engage in physical activity daily
• C. Increase the dose of regular insulin
• D. Eat a protein and carbohydrate snack at bedtime

Correct answer: D

Rationale: Somogyi effect, also known as rebound hyperglycemia, occurs as a response to nighttime hypoglycemia. Eating a protein and carbohydrate snack at bedtime can help prevent this by stabilizing blood sugar levels throughout the night. Instructing the client to take insulin at 2:00 PM each day (Choice A) may not directly address the nighttime hypoglycemia concern. Engaging in physical activity daily (Choice B) is generally beneficial for diabetes management but may not specifically prevent Somogyi's effect. Increasing the dose of regular insulin (Choice C) without addressing the nighttime hypoglycemia issue can exacerbate the problem.

2. Which statement about appendicitis is accurate and true?

• A. Appendicitis is more common among females than males.
• B. A high fiber diet is a risk factor associated with appendicitis.
• C. Left lower quadrant pain is suggestive of appendicitis.
• D. McBurney's point tenderness is suggestive of appendicitis.

Correct answer: D

Rationale: The correct answer is D: McBurney's point tenderness is suggestive of appendicitis. McBurney's point is located in the right lower abdomen and tenderness at this point is a classic sign of appendicitis. Choice A is incorrect as appendicitis is slightly more common in males than females. Choice B is incorrect as a high fiber diet is actually considered to be protective against appendicitis. Choice C is incorrect as appendicitis typically presents with pain in the right lower quadrant, not the left.

3. Which of the following changes was enacted by the Patient Protection and Affordable Care Act?

• A. Creation of national health insurance exchanges for affordable insurance coverage
• B. Expansion of school-based health centers
• C. Free preventative services for all
• D. Medically managed clinics eligible for federal funding

Correct answer: B

Rationale: The correct answer is B. The Patient Protection and Affordable Care Act expanded school-based health centers to provide additional healthcare services to students. Choice A is incorrect because the creation of national health insurance exchanges was a key provision of the Affordable Care Act, but it was not the only change enacted by the legislation. Choice C is incorrect as while the Affordable Care Act did include provisions for free preventative services for certain groups, it was not applicable to all individuals. Choice D is incorrect as the Act did not specifically address medically managed clinics eligible for federal funding.

4. Which of the following is the best way to improve nursing's image?

• A. Uniforms should reflect your professionalism.
• B. Introduce yourself with your full name.
• C. Understand the essence of professional behavior in your practice.
• D. Take every opportunity to speak to the public about nursing.

Correct answer: D

Rationale: The correct answer is D because taking every chance to engage with the public about nursing allows for the improvement of nursing's image and the promotion of the profession. Choice A is incorrect as uniforms should reflect professionalism rather than personality. Choice B is not directly related to improving nursing's image. Choice C, while important, does not directly address improving the image of nursing through public engagement.

5. A healthcare provider is caring for a client who has anorexia nervosa. Which of the following interdisciplinary team members should be consulted in regards to client care?

• A. Occupational therapist
• B. Case manager
• C. Nutritionist
• D. Psychiatrist

Correct answer: B

Rationale: A case manager is the most appropriate interdisciplinary team member to consult for a client with anorexia nervosa. They can help coordinate care, resources, and communication between various healthcare professionals involved in the client's treatment. Consulting an occupational therapist (Choice A) may not directly address the primary concerns associated with anorexia nervosa. While nutritional therapists (Choice C) play a role in addressing nutritional needs, a case manager is better suited for overall care coordination. Mental health counselors (Choice D) focus more on emotional and psychological aspects, whereas a case manager coordinates practical aspects of care.

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