Nursing Elites

1. A client with diabetes mellitus is receiving an oral antidiabetic medication. The nurse should monitor for which of the following adverse effects?

• A. Weight gain
• B. Hypoglycemia
• C. Hyperglycemia
• D. Bradycardia

Correct answer: B

Rationale: The correct answer is B: Hypoglycemia. When a client with diabetes mellitus is taking oral antidiabetic medication, the nurse should closely monitor for hypoglycemia, which is a common adverse effect. Hypoglycemia occurs when the blood sugar levels drop below normal range, leading to symptoms like confusion, shakiness, and sweating. Weight gain (Choice A) is not a typical adverse effect of oral antidiabetic medications. Hyperglycemia (Choice C) is the opposite of the desired effect of antidiabetic medications, which aim to lower blood sugar levels. Bradycardia (Choice D) is not directly associated with oral antidiabetic medications; it refers to a slow heart rate.

2. A nurse manager in the emergency department considers policy changes in the organization and changes in the community, and tries to predict how these may impact the functioning of the unit. Which of the following decisional activities best describes this manager’s actions?

• A. Resource allocation
• B. Monitoring
• C. Job analysis and redesign
• D. Planning for the future

Correct answer: D

Rationale: The correct answer is D: Planning for the future. In this scenario, the nurse manager is engaging in decisional activities related to planning for the future. This involves analyzing potential impacts of policy changes and community shifts on the unit's functioning and making decisions based on predictions and foresight. Option A, resource allocation, focuses on distributing resources effectively. Option B, monitoring, involves observing and assessing current activities. Option C, job analysis and redesign, pertains to evaluating and restructuring roles and responsibilities within the unit, which is not the primary focus of the scenario provided.

3. The client with newly diagnosed diabetes mellitus is receiving education from the nurse on managing blood glucose levels. Which statement indicates a need for further teaching?

• A. I will monitor my blood glucose levels regularly.
• B. I can eat whatever I want as long as I take my medication.
• C. I should exercise regularly to help control my blood sugar.
• D. I will rotate my injection sites to avoid tissue damage.

Correct answer: B

Rationale: Choice B indicates a need for further teaching because it suggests that the client can eat whatever they want as long as they take their medication, which is incorrect. Clients with diabetes mellitus need to follow a healthy and balanced diet in addition to taking their medication to effectively manage blood glucose levels. Choices A, C, and D are correct statements for managing diabetes. Monitoring blood glucose levels regularly, engaging in regular exercise to help control blood sugar, and rotating injection sites to avoid tissue damage are all important aspects of diabetes management.

4. A client with type 1 DM is taught to take NPH and regular insulin every morning. The nurse should provide which instructions to the client?

• A. Take the NPH insulin first, then the regular insulin.
• B. Take the regular insulin first, then the NPH insulin.
• C. It does not matter which insulin is drawn up first.
• D. Contact the healthcare provider if the order for insulin is unclear.

Correct answer: B

Rationale: The correct answer is to take the regular insulin first, then the NPH insulin. Regular insulin should be drawn up before NPH insulin to prevent contamination of the regular insulin vial with the longer-acting insulin. Choice A is incorrect as it suggests taking the NPH insulin first, which is not the recommended practice. Choice C is incorrect because the order of drawing up insulin does matter to prevent contamination. Choice D is not the most appropriate action in this scenario, as the nurse should provide clear instructions to the client based on best practices.

5. A nurse caring for a group of clients reviews the electrolyte laboratory results and notes a potassium level of 5.5 mEq/L on one client's laboratory report. The nurse understands that which client is at highest risk for the development of a potassium value at this level?

• A. The client with colitis
• B. The client with Cushing's syndrome
• C. The client who has been overusing laxatives
• D. The client who has sustained a traumatic burn

Correct answer: D

Rationale: Clients who have sustained traumatic burns are at a higher risk of developing hyperkalemia due to cell lysis. When cells are damaged in a traumatic burn, potassium can leak out from the intracellular space into the bloodstream, leading to elevated serum potassium levels. Colitis, Cushing's syndrome, and overuse of laxatives are not typically associated with the same degree of cell damage or potassium shifts seen in traumatic burns, making them less likely to result in such high potassium levels.

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