Nursing Elites

1. A client with diabetes mellitus is experiencing polyuria, polydipsia, and polyphagia. What do these symptoms indicate?

• A. Hypoglycemia
• B. Diabetic ketoacidosis (DKA)
• C. Hyperosmolar hyperglycemic state (HHS)
• D. Insulin shock

Correct answer: B

Rationale: Polyuria, polydipsia, and polyphagia are classic signs of diabetic ketoacidosis (DKA), which occurs due to a combination of hyperglycemia and ketone production. Hypoglycemia (Choice A) is characterized by low blood sugar levels, leading to symptoms like confusion, shakiness, and sweating, which are different from the symptoms described in the scenario. Hyperosmolar hyperglycemic state (HHS) (Choice C) typically presents with severe hyperglycemia, dehydration, and altered mental status, rather than the triad of symptoms mentioned. Insulin shock (Choice D) refers to a severe hypoglycemic reaction due to excessive insulin, manifesting with confusion, sweating, and rapid heartbeat, not the symptoms seen in the client with diabetes mellitus described in this scenario.

2. The healthcare provider prescribes Cytovene 375 mg every 12 hours to infuse over 90 minutes. The pharmacy delivers Cytovene 375 mg in a 150 mL IV bag. How many ml/hour should the nurse program the infusion pump?

• A. 50 ml/hour.
• B. 75 ml/hour.
• C. 100 ml/hour.
• D. 125 ml/hour.

Correct answer: C

Rationale: To infuse 150 mL over 90 minutes, the pump should be set to 100 ml/hour (150 mL / 1.5 hours). This rate ensures that the medication is delivered at the proper rate as prescribed. Choices A, B, and D are incorrect because they do not reflect the correct calculation based on the volume of the IV bag and the infusion duration provided in the question.

3. During the admission interview, an older client answers some questions inappropriately. The nurse notes that a hearing aid is in one ear. Which intervention is most helpful in assisting the client to hear the nurse’s question?

• A. Move to the client's other side.
• B. Speak louder into the client's ear with the hearing aid.
• C. Ask the client to adjust the hearing aid volume.
• D. Restate questions articulating consonants carefully.

Correct answer: D

Rationale: Restating questions with clear articulation is the most helpful intervention in assisting the client to hear the nurse's question. This approach ensures that the client can better understand the question, especially if there are issues with the hearing aid. Moving to the client's other side or speaking louder into the ear with the hearing aid may not effectively address the problem of clarity in communication. Asking the client to adjust the hearing aid volume assumes that the issue lies solely with the volume, while restating questions with clear articulation can help overcome various hearing difficulties.

4. A young client who is being taught how to use an inhaler for symptoms of asthma tells the nurse about the intention to use the inhaler but plans to continue smoking cigarettes. In evaluating the client’s response, what is the best initial action by the nurse?

• A. Explain the risks of smoking with asthma.
• B. Revise the plan of care.
• C. Encourage the client to reduce smoking gradually.
• D. Provide resources for smoking cessation.

Correct answer: B

Rationale: The best initial action by the nurse is to revise the plan of care. This is necessary to address the client's intention to continue smoking and ensure that appropriate support and education are provided. Choice A is not the best initial action as the client is already aware of the risks of smoking with asthma. Choice C might not be effective as the client's intention to continue smoking poses a significant risk to their health. Choice D, providing resources for smoking cessation, is important but revising the plan of care should come first to address the immediate concern.

5. The nurse is teaching a client with gastroesophageal reflux disease (GERD) about dietary modifications. Which food should the client avoid?

• A. Applesauce
• B. White rice
• C. Coffee
• D. Bananas

Correct answer: C

Rationale: The correct answer is C: Coffee. Coffee should be avoided by clients with GERD as it can relax the lower esophageal sphincter, leading to an increase in GERD symptoms. Choices A, B, and D are not directly associated with worsening GERD symptoms and can be included in moderation in the diet of a client with GERD.

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