Nursing Elites

1. A client with DM is scheduled for surgery. The nurse should plan to:

• A. Monitor the client's blood glucose level closely during the perioperative period.
• B. Give the client a regular diet as ordered.
• C. Have the client stop taking insulin 48 hours before surgery.
• D. Hold the client's insulin on the morning of surgery.

Correct answer: A

Rationale: The correct answer is to monitor the client's blood glucose level closely during the perioperative period. For a client with diabetes mellitus (DM) scheduled for surgery, it is essential to closely monitor blood glucose levels to prevent hypo- or hyperglycemia. Choice B is incorrect because giving the client a regular diet as ordered may not address the specific needs related to managing blood glucose levels in the perioperative period. Choice C is incorrect as abruptly stopping insulin 48 hours before surgery can lead to uncontrolled blood sugar levels, which is not recommended. Choice D is incorrect because holding the client's insulin on the morning of surgery can also disrupt blood sugar control, potentially leading to complications during the perioperative period.

2. A client with type 1 diabetes mellitus is experiencing hypoglycemia. What should the nurse instruct the client to do?

• A. Administer insulin immediately
• B. Consume 15 grams of simple carbohydrates
• C. Drink plenty of water
• D. Avoid eating until symptoms resolve

Correct answer: B

Rationale: When a client with type 1 diabetes mellitus experiences hypoglycemia, the nurse should instruct them to consume 15 grams of simple carbohydrates. This is the recommended initial treatment for hypoglycemia as it helps quickly raise blood sugar levels to alleviate symptoms and prevent complications. Administering insulin immediately (Choice A) would further lower blood sugar levels, worsening the hypoglycemia. Drinking plenty of water (Choice C) and avoiding eating until symptoms resolve (Choice D) are not appropriate actions for treating hypoglycemia as they do not address the immediate need to raise blood sugar levels.

3. The healthcare provider is assessing a client with suspected syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following laboratory findings is most consistent with this condition?

• A. Increased serum sodium
• B. Decreased urine specific gravity
• C. Decreased serum osmolality
• D. Increased serum potassium

Correct answer: C

Rationale: The correct answer is C: Decreased serum osmolality. Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by the excessive release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. The dilution of sodium results in decreased serum osmolality. Option A is incorrect because SIADH causes hyponatremia, resulting in decreased serum sodium levels. Option B is incorrect because SIADH leads to concentrated urine with increased urine specific gravity. Option D is incorrect as SIADH does not typically affect serum potassium levels.

4. The nurse is preparing to administer NPH insulin to a client. The nurse should administer the insulin at which site for the best absorption?

• A. The deltoid muscle
• B. The anterior thigh
• C. The abdomen
• D. The gluteal muscle

Correct answer: C

Rationale: The abdomen is the preferred site for insulin injection due to its consistent absorption rate. Insulin injected into the abdomen is absorbed more consistently and predictably than in other sites. The deltoid muscle and the anterior thigh are not recommended for insulin injections due to inconsistent absorption rates. The gluteal muscle is avoided for insulin injections due to the risk of hitting the sciatic nerve or causing discomfort to the client.

5. Which of the following is true about effective leadership?

• A. Leadership traits can be learned through experience and reflection.
• B. Nurses can learn to become good leaders by acting as good leaders and reflecting on leadership qualities they have and those they can improve upon.
• C. Focus on leadership activities required for the day is essential for effective leadership.
• D. Taking advantage of every opportunity to be a leader is crucial, creating those opportunities as often as possible, especially after gaining experience as a nurse.

Correct answer: B

Rationale: Choice B is correct because nurses can develop effective leadership skills by actively engaging as good leaders and reflecting on their existing leadership qualities and areas for improvement. This process of self-assessment and continuous improvement is crucial in becoming a successful leader. Choice A is incorrect as leadership traits can be learned through experience and reflection rather than being impossible to acquire from a book. Choice C is incorrect as effective leadership involves focusing on long-term goals and strategies, not just daily activities. Choice D is incorrect because while seizing leadership opportunities is important, it should be done strategically and with a solid foundation of experience in nursing to ensure successful leadership outcomes.

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