Nursing Elites

1. What clinical feature distinguishes a hypoglycemic reaction from a ketoacidosis reaction?

• A. Blurred vision.
• B. Diaphoresis.
• C. Nausea.
• D. Weakness.

Correct answer: B

Rationale: Diaphoresis is the correct answer because it is more characteristic of hypoglycemia. Hypoglycemia typically presents with symptoms such as diaphoresis (excessive sweating), palpitations, tremors, and anxiety. On the other hand, ketoacidosis is associated with symptoms such as fruity breath, deep and labored breathing (Kussmaul respirations), nausea, vomiting, and abdominal pain. Blurred vision can occur in both hypoglycemia and ketoacidosis due to metabolic disturbances affecting the eyes. Weakness is a nonspecific symptom that can be present in both conditions, making it less helpful in distinguishing between the two.

2. A nurse manager conducts evaluations with each staff member and reviews the staffing needs for the upcoming year. Which of the following best describes the behavior this manager is engaging in?

• A. Interpersonal activities
• B. Decisional activities
• C. Informational activities
• D. Transformational activities

Correct answer: B

Rationale: The correct answer is B: Decisional activities. A nurse manager conducting evaluations and reviewing staffing needs for the future involves making decisions related to resource allocation, planning, and problem-solving. These activities fall under the category of decisional activities in management. Choice A, Interpersonal activities, would involve activities like communicating, motivating, and leading staff. Choice C, Informational activities, would involve activities like gathering and disseminating information. Choice D, Transformational activities, would involve inspiring and motivating staff to achieve organizational goals through vision and change.

3. The client with DM is being taught about the signs of hyperglycemia. Which symptom should the nurse include?

• A. Excessive thirst
• B. Sweating
• C. Shaking
• D. Hunger

Correct answer: A

Rationale: Excessive thirst, also known as polydipsia, is a hallmark symptom of hyperglycemia. When blood glucose levels are high, the body tries to eliminate the excess glucose through urine, leading to increased urination and subsequent thirst. Sweating, shaking, and hunger are more commonly associated with hypoglycemia, not hyperglycemia. Sweating can occur when blood sugar levels drop too low, shaking is a sign of hypoglycemia, and hunger is often a result of low blood sugar levels triggering the body to seek fuel.

4. A male client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate?

• A. Infusing I.V. fluids rapidly as ordered
• B. Encouraging increased oral intake
• C. Restricting fluids
• D. Administering glucose-containing I.V. fluids as ordered

Correct answer: C

Rationale: The correct nursing intervention for a male client with SIADH is to restrict fluids. In SIADH, there is excess release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. Restricting fluids helps prevent further dilutional hyponatremia by reducing water intake. Infusing I.V. fluids rapidly (choice A) would worsen the condition by adding more fluids, encouraging increased oral intake (choice B) is contraindicated as it adds more fluids, and administering glucose-containing I.V. fluids (choice D) is not a standard treatment for SIADH.

5. The client with type 1 DM asks why it is necessary to rotate injection sites when managing insulin therapy. The nurse's best response is:

• A. It helps prevent skin irritation.
• B. It helps prevent scar tissue buildup.
• C. It ensures more consistent insulin absorption.
• D. It makes the injections less painful.

Correct answer: C

Rationale: Rotating injection sites is necessary to ensure more consistent insulin absorption. This practice helps maintain stable blood glucose levels by preventing the formation of lipohypertrophy (fatty lumps under the skin) at injection sites. Choices A and B are incorrect as the primary purpose of rotating injection sites is not focused on preventing skin irritation or scar tissue buildup. While rotating injection sites may contribute to reducing pain over time, the primary benefit is the consistency in insulin absorption to support glycemic control, making choice D less relevant.

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