Nursing Elites

1. A client with type 1 diabetes mellitus is learning to administer insulin. What is the best site for the nurse to recommend for insulin injection?

• A. Abdomen
• B. Thigh
• C. Upper arm
• D. Buttock

Correct answer: A

Rationale: The correct answer is the abdomen. The abdomen is the recommended site for insulin injection due to its faster absorption rate compared to other sites. Insulin injected into the abdomen is absorbed more quickly, leading to better glycemic control. The thigh and upper arm are also common sites for insulin injection, but they have slower absorption rates than the abdomen. The buttock is not a preferred site for insulin injection due to inconsistent absorption and potential risk of injecting into muscle instead of fatty tissue.

2. The nurse is palpating the right upper hypochondriac region of the abdomen of a client. What organ lies underneath this area?

• A. Duodenum
• B. Gastric pylorus
• C. Liver
• D. Spleen

Correct answer: C

Rationale: The correct answer is C: Liver. The liver is located in the right upper hypochondriac region of the abdomen. The duodenum (Choice A) is located in the right upper quadrant but not directly underneath the right upper hypochondriac region. The gastric pylorus (Choice B) is part of the stomach and is located more centrally in the abdomen. The spleen (Choice D) is located in the left upper quadrant of the abdomen, not underneath the right upper hypochondriac region.

3. A 9-year-old is receiving vancomycin 400 mg IV every 6 hours for a methicillin-resistant (Beta-lactam-resistant) Staphylococci aureus (MRSA) infection. The medication is diluted in a 100 mL bag of saline with instructions to infuse over one and a half hours. How many mL/hour should the nurse program the infusion pump?

• A. 50
• B. 67
• C. 57
• D. 70

Correct answer: B

Rationale: To calculate the infusion rate for vancomycin, you need to divide the total volume by the total time of infusion. In this case, the total volume is 100 mL, and the total time is 1.5 hours. Therefore, 100 mL ÷ 1.5 hours = 67 mL/hour. This means the nurse should program the infusion pump to deliver vancomycin at a rate of 67 mL/hour. Choice A (50) is incorrect as it does not reflect the correct calculation. Choice C (57) is incorrect as it is not the accurate calculation based on the provided information. Choice D (70) is incorrect as it does not correspond to the correct infusion rate calculation.

4. A healthcare provider is conducting a health education session about the prevention of type 2 diabetes. What lifestyle modification should be emphasized?

• A. Increasing physical activity
• B. Reducing dietary sugar intake
• C. Regular health screenings
• D. All of the above

Correct answer: D

Rationale: To effectively prevent type 2 diabetes, individuals should focus on a combination of lifestyle modifications. Increasing physical activity helps maintain a healthy weight and improves insulin sensitivity. Reducing dietary sugar intake can lower the risk of developing diabetes by managing blood sugar levels. Regular health screenings are crucial for early detection and timely intervention. Emphasizing all these modifications together provides a comprehensive approach to diabetes prevention. Choices A, B, and C are all important components of a healthy lifestyle that can contribute to reducing the risk of type 2 diabetes.

5. During a bed bath, the nurse observes that a client's IV site is red and swollen. What should the nurse do first?

• A. Discontinue the IV under physician's guidance
• B. Apply a warm compress to the site
• C. Notify the physician
• D. Document the appearance of the site and continue the bath

Correct answer: C

Rationale: The correct first action when a nurse observes a red and swollen IV site during a bed bath is to notify the physician. This is crucial because prompt reporting allows for immediate intervention to prevent further complications. Discontinuing the IV (Choice A) should only be done under the physician's guidance to avoid any adverse effects and ensure proper care. Applying a warm compress (Choice B) may not address the underlying issue and could potentially worsen the situation if the cause is an infection or infiltration. Documenting the site's appearance and continuing the bath (Choice D) without immediate action might delay necessary treatment, leading to potential complications.

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