Nursing Elites

1. A male client with type 1 diabetes mellitus has a highly elevated glycosylated hemoglobin (Hb) test result. In discussing the result with the client, nurse Sharmaine would be most accurate in stating:

• A. The test needs to be repeated following a 12-hour fast.
• B. It appears you aren't following the prescribed diabetic diet.
• C. It tells us about your sugar control for the last 3 months.
• D. Your insulin regimen needs to be significantly altered.

Correct answer: C

Rationale: The correct answer is C. Glycosylated hemoglobin (HbA1c) reflects average blood glucose levels over the past 3 months. This test is used to assess long-term blood sugar control in individuals with diabetes. Choice A is incorrect because fasting is not required for an HbA1c test. Choice B is judgmental and not supported by the information provided. Choice D is not the most accurate statement to make based on the HbA1c result; adjusting insulin would depend on a more comprehensive assessment of the client's overall diabetes management.

2. The nurse is caring for a client with primary adrenal insufficiency (Addison's disease). Which of the following laboratory findings would the nurse expect?

• A. Hypernatremia
• B. Hyperkalemia
• C. Hyperglycemia
• D. Hypercalcemia

Correct answer: B

Rationale: In primary adrenal insufficiency (Addison's disease), there is a decrease in aldosterone levels, leading to sodium loss and potassium retention. This imbalance results in hyperkalemia, making choice B the correct answer. Hypernatremia (choice A) is unlikely due to sodium loss. Hyperglycemia (choice C) and hypercalcemia (choice D) are not typically associated with primary adrenal insufficiency.

3. Which of the following best describes the nurse's role in patient education?

• A. The nurse is responsible for providing patients with information they need to make informed decisions about their care.
• B. The nurse provides education to the patient and their family to help them understand the care plan and make informed decisions.
• C. The nurse is responsible for providing patients with written materials to help them understand their condition and treatment options.
• D. The nurse provides patients with verbal and written instructions on how to manage their care at home.

Correct answer: A

Rationale: The correct answer is A. The nurse's role in patient education involves providing patients with the necessary information to make informed decisions about their care. This includes explaining treatment options, potential risks and benefits, and answering any questions the patient may have. Choice B is incorrect because while nurses do educate patients and families, the primary focus is on empowering patients to make informed decisions. Choice C is incorrect as providing written materials is a part of patient education but not the sole responsibility of the nurse. Choice D is incorrect because while nurses do provide instructions on managing care at home, patient education goes beyond just the home care aspect to encompass a broader understanding of the patient's condition and treatment.

4. A new nurse is working hard to follow the established procedures on the unit and is focusing on being as efficient as possible. Which of the following best describes this nurse’s behavior?

• A. The nurse is demonstrating the concept of efficiency, which involves following established procedures to complete tasks in the most effective way possible.
• B. The nurse is demonstrating the concept of task orientation, which focuses on completing tasks efficiently without necessarily considering the impact on patient care.
• C. The nurse is demonstrating the concept of patient-centered care, which focuses on providing care that is respectful of and responsive to individual patient preferences and needs.
• D. The nurse is demonstrating the concept of transformational leadership, which involves inspiring and motivating others to achieve a higher level of performance.

Correct answer: A

Rationale: The correct answer is A: The nurse is demonstrating the concept of efficiency by following established procedures to complete tasks effectively. Efficiency in healthcare involves optimizing processes and resources to achieve the best outcomes. Choice B is incorrect as task orientation refers to focusing on task completion without considering broader aspects like patient care. Choice C is incorrect as patient-centered care emphasizes individual patient needs and preferences rather than operational efficiency. Choice D is incorrect as transformational leadership involves inspiring and motivating others, not specifically related to task efficiency.

5. The client with type 2 DM is being taught about the importance of foot care. Which instruction should be included?

• A. Soak your feet in hot water every night.
• B. Walk barefoot whenever possible.
• C. Use a heating pad to warm your feet.
• D. Wear comfortable shoes that allow air circulation.

Correct answer: D

Rationale: The correct instruction for the client with type 2 DM regarding foot care is to wear comfortable shoes that allow air circulation. This helps prevent foot injuries and infections, which are common complications in clients with diabetes. Choice A is incorrect as soaking feet in hot water can lead to burns and skin damage. Choice B is incorrect because walking barefoot increases the risk of injury and infection. Choice C is incorrect as using a heating pad can also potentially lead to burns and skin damage.

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