Nursing Elites

1. A female client is admitted for a diabetic crisis resulting from inadequate dietary practices. After stabilization, the nurse talks to the client about her prescribed diet. What client characteristic is most important for successful adherence to the diabetic diet?

• A. Understands the importance of timing insulin administration 30 minutes before eating
• B. Frequently includes fruits and vegetables in meals and snacks
• C. Has access to someone who can assist with meal preparation and monitoring
• D. Demonstrates willingness to consistently follow the prescribed diet

Correct answer: D

Rationale: The most crucial characteristic for successful adherence to a diabetic diet is the client's willingness to consistently follow the prescribed diet plan. Option A, understanding insulin timing, is important for treatment but not directly related to dietary adherence. Option B, consuming fruits and vegetables, is a healthy practice but does not ensure adherence to a specific diabetic diet. Option C, having assistance with meal preparation, is beneficial but not as essential as the client's personal commitment to adhering to the diet consistently.

2. Where should the nurse choose as the best location to begin a screening program for hypothyroidism?

• A. A business and professional women's group.
• B. An African-American senior citizens center.
• C. A daycare center in a Hispanic neighborhood.
• D. An after-school center for Native-American teens.

Correct answer: B

Rationale: The best location for beginning a screening program for hypothyroidism would be an African-American senior citizens center. This choice is the most suitable as hypothyroidism is more prevalent among older adults, and African-American seniors are at a higher risk for this condition due to various factors like genetics and lifestyle. Choices A, C, and D are less appropriate because hypothyroidism is not specifically linked to business and professional women, Hispanic children, or Native-American teens. Targeting the high-risk group, which in this case, are African-American seniors, increases the chances of successful screening and early detection.

3. Which assessment finding is most indicative of deep vein thrombosis (DVT) in a client’s right leg?

• A. Dorsiflexes the right foot and left foot on command
• B. A 3 by 5 cm ecchymosis area on the right calf
• C. Right calf is 3 cm larger in circumference than the left calf
• D. Bilateral lower extremities have 3+ pitting edema

Correct answer: C

Rationale: The correct answer is C because a significant difference in calf circumference between the legs is a classic sign of DVT. This is due to the obstruction of blood flow in the deep veins of the leg, leading to swelling in the affected limb. Choices A, B, and D are not typical findings of DVT. Choice A describes a neurological response, choice B indicates a bruise on the right calf, and choice D describes pitting edema in both lower extremities, which are not specific signs of DVT.

4. The nurse notes that a depressed female client has been more withdrawn and non-communicative during the past two weeks. Which intervention is most important to include in the updated plan of care for this client?

• A. Encourage the client's family to visit more often
• B. Schedule a daily conference with the social worker
• C. Encourage the client to participate in group activities
• D. Engage the client in a non-threatening conversation

Correct answer: D

Rationale: Engaging the client in a non-threatening conversation is crucial as it can help build trust and provide support, addressing the client's withdrawal. This intervention focuses on establishing a therapeutic relationship and giving the client an opportunity to express their feelings. Choices A, B, and C do not directly target the client's need for communication and may not address the underlying issues contributing to her withdrawal. Encouraging the client's family to visit more often (Choice A) may add pressure or discomfort to the client. Scheduling a daily conference with the social worker (Choice B) may not address the client's immediate need for communication. Encouraging the client to participate in group activities (Choice C) may be overwhelming for the client and not address her withdrawal directly.

5. The nurse is assessing a client with Addison's disease who is weak, dizzy, disoriented, and has dry oral mucous membranes, poor skin turgor, and sunken eyes. Vital signs are blood pressure 94/44, heart rate 123 beats/minute, respiration 22 breaths/minute. Which intervention should the nurse implement first?

• A. Assess extremity strength and resistance
• B. Report a sodium level of 132 mEq/L or mmol/L (SI units)
• C. Measure and record the cardiac QRS complex
• D. Check current finger stick glucose

Correct answer: D

Rationale: The client’s symptoms suggest possible adrenal crisis or hypoglycemia. Checking glucose is a priority to rule out hypoglycemia, which requires immediate intervention. The client is presenting with symptoms indicative of hypoglycemia, which can be life-threatening if not promptly addressed. Assessing extremity strength, reporting sodium levels, or measuring the cardiac QRS complex are not the most urgent actions in this scenario.

Similar Questions