Nursing Elites

1. A client with diabetes is taking insulin lispro (Humalog) injections. The nurse should advise the client to eat:

• A. Within 10 to 15 minutes after the injection.
• B. 1 hour after the injection.
• C. At any time, because timing of meals with lispro injections is unnecessary.
• D. 2 hours before the injection.

Correct answer: A

Rationale: The correct answer is to eat within 10 to 15 minutes after the injection. Insulin lispro, also known as Humalog, is a rapid-acting insulin that starts working very quickly. Eating shortly after the injection helps match the food intake with the insulin action, reducing the risk of hypoglycemia. Choice B is incorrect because waiting 1 hour after the injection may lead to a mismatch between insulin activity and food intake. Choice C is incorrect as timing meals with lispro injections is essential to optimize glycemic control. Choice D is incorrect as eating 2 hours before the injection is not in alignment with the rapid action of insulin lispro and may lead to fluctuations in blood sugar levels.

2. An adult female client has undergone a routine health screening in the clinic. Which of the following values indicates to the nurse who receives the report of the client’s laboratory work that the client’s hematocrit is normal?

• A. 10%
• B. 22%
• C. 30%
• D. 43%

Correct answer: D

Rationale: The normal hematocrit for an adult female client ranges from 35% to 47%. A hematocrit value of 43% falls within this normal range, indicating normal levels of red blood cells. Choices A, B, and C are low hematocrit values and are considered below the normal range for adult females, signifying potential anemia or other health issues.

3. A nurse assesses clients on the medical-surgical unit. Which client is at greatest risk for bladder cancer?

• A. A 25-year-old female with a history of sexually transmitted diseases
• B. A 42-year-old male who has worked in a lumber yard for 10 years
• C. A 55-year-old female who has had numerous episodes of bacterial cystitis
• D. An 86-year-old male with a 50–pack-year cigarette smoking history

Correct answer: D

Rationale: The correct answer is D. The greatest risk factor for bladder cancer is a long history of tobacco use, which is reflected in an 86-year-old male with a 50–pack-year cigarette smoking history. Smoking is a well-established risk factor for developing bladder cancer. Choices A, B, and C are not directly linked to an increased risk of bladder cancer. While sexually transmitted diseases, certain occupational exposures, and recurrent urinary tract infections may pose other health risks, they are not specifically associated with an elevated risk of bladder cancer.

4. A client with heart disease is on a continuous telemetry monitor and has developed sinus bradycardia. In determining the possible cause of the bradycardia, the nurse assesses the client's medication record. Which medication is most likely the cause of the bradycardia?

• A. Propranolol (Inderal).
• B. Captopril (Capoten).
• C. Furosemide (Lasix).
• D. Dobutamine (Dobutrex).

Correct answer: A

Rationale: Propranolol (Inderal) is a beta-adrenergic blocking agent that acts to decrease heart rate and contractility. Sinus bradycardia is a common side effect of beta blockers due to their negative chronotropic effect on the heart. Captopril (Capoten) is an ACE inhibitor used for hypertension and heart failure, not associated with causing bradycardia. Furosemide (Lasix) is a loop diuretic that can lead to electrolyte imbalances but not commonly linked to bradycardia. Dobutamine (Dobutrex) is a beta-1 adrenergic agonist that increases heart rate and contractility, making it an unlikely cause of bradycardia in this scenario.

5. A client with nephrotic syndrome is being assessed by a nurse. For which clinical manifestations should the nurse assess? (Select all that apply.)

• A. Proteinuria
• B. Hypoalbuminemia
• C. Lipiduria
• D. All of the above

Correct answer: D

Rationale: Nephrotic syndrome is characterized by glomerular damage, leading to proteinuria (excessive protein in the urine), hypoalbuminemia (low levels of albumin in the blood), and lipiduria (lipids in the urine). These manifestations are key indicators of nephrotic syndrome. Edema, often severe, is also common due to decreased plasma oncotic pressure from hypoalbuminemia. The correct answer is 'All of the above' because all three manifestations are associated with nephrotic syndrome. Dehydration is not a typical finding in nephrotic syndrome as it is more commonly associated with fluid retention and edema. Dysuria is a symptom of cystitis, not nephrotic syndrome. CVA tenderness is more indicative of inflammatory changes in the kidney rather than nephrotic syndrome.

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