Nursing Elites

1. A client with diabetes mellitus is receiving insulin glargine (Lantus). The nurse should monitor the client for which of the following side effects?

• A. Hypoglycemia
• B. Hyperkalemia
• C. Hypertension
• D. Hypercalcemia

Correct answer: A

Rationale: Insulin glargine is a long-acting insulin used to control blood sugar levels in diabetes. The nurse should monitor the client for hypoglycemia, which is a potential side effect of insulin therapy. Hypoglycemia occurs when blood sugar levels drop too low, leading to symptoms such as shakiness, dizziness, sweating, confusion, and in severe cases, loss of consciousness. Hyperkalemia (choice B) is an elevated potassium level, not typically associated with insulin glargine. Hypertension (choice C) is high blood pressure, which is not a common side effect of insulin glargine. Hypercalcemia (choice D) is an elevated calcium level and is not related to the use of insulin glargine.

2. When the nurse identifies what appears to be ventricular tachycardia on the cardiac monitor of a client being evaluated for possible myocardial infarction, the first action the nurse should perform is to

• A. Begin cardiopulmonary resuscitation
• B. Prepare for immediate defibrillation
• C. Notify the 'Code' team and healthcare provider
• D. Assess airway, breathing, and circulation

Correct answer: D

Rationale: The correct first action for the nurse to take when identifying what appears to be ventricular tachycardia in a client being evaluated for possible myocardial infarction is to assess the client's airway, breathing, and circulation. This step is crucial to determine the client's stability and the need for immediate intervention. Beginning cardiopulmonary resuscitation or preparing for immediate defibrillation without first assessing the airway, breathing, and circulation could delay potentially life-saving interventions. Notifying the 'Code' team and healthcare provider should come after ensuring the client's immediate needs are addressed.

3. Which intervention should the public health nurse implement to address one of the leading health indicators of Healthy People 2020?

• A. Lead a weekly water aerobics class for the elderly at a community center.
• B. Teach a class on cultural awareness to nursing students at the university.
• C. Design and implement a no smoking campaign at the local high school.
• D. Write a grant to help provide glucometers to individuals who cannot afford one.

Correct answer: C

Rationale: Designing and implementing a no smoking campaign aligns with the objective of reducing tobacco use, which is one of the leading health indicators of Healthy People 2020. This intervention directly targets a significant public health concern. Leading a water aerobics class, teaching cultural awareness, or providing glucometers, while beneficial in other contexts, do not specifically address the leading health indicators outlined by Healthy People 2020.

4. The milk code aims to ensure that:

• A. the public receives accurate information about breastmilk and breastfeeding
• B. health workers do not provide samples of infant formula to pregnant women or mothers of infants
• C. companies consistently recognize the superiority of breastmilk
• D. health workers do not accept any incentives from milk companies

Correct answer: C

Rationale: The correct answer is C because the milk code emphasizes that companies should always acknowledge the superiority of breastmilk over formula. Choice A is incorrect because the focus is not on the public receiving information, but rather on companies recognizing breastmilk's superiority. Choice B is incorrect as it addresses health workers' actions, not the companies' behavior. Choice D is incorrect as the milk code is primarily concerned with regulating companies' practices, not health workers' acceptance of incentives.

5. A community health RN believes that immunization rates in a lower socioeconomic section of the city are probably below the target set by the state health department. What action should the RN take FIRST to intervene with this health problem?

• A. Take a health history of the members of the community
• B. Initiate an immunization program for the community
• C. Review current epidemiological population data that might document a low immunization rate
• D. Refer all clients to the local health department

Correct answer: C

Rationale: The correct first action for the community health RN to take in this situation is to review current epidemiological population data that might document a low immunization rate. By doing so, the RN can gather evidence to support further intervention strategies. Option A is incorrect because taking a health history would not provide immediate data on immunization rates in the community. Option B is incorrect as initiating an immunization program without confirming the actual immunization rates may not address the specific needs of the community. Option D is incorrect as a blanket referral without assessing the situation may not be the most effective first step.

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