Nursing Elites

1. A new unit manager works hard to get to know each of the staff members on the unit and determine what each staff member needs in order to effectively do their job. What type of management best describes this manager?

• A. Servant leader-style manager
• B. Networking manager
• C. Coaching manager
• D. Monitoring manager

Correct answer: A

Rationale: A Servant leader-style manager focuses on understanding and meeting the needs of staff members to help them grow and perform at their best. This type of manager prioritizes serving the team and facilitating their development. Networking managers focus on building connections and relationships outside the team. Coaching managers provide guidance, support, and feedback to help employees improve. Monitoring managers primarily oversee and supervise tasks without a strong emphasis on individual needs or growth.

2. 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.

3. The client with DM is being instructed by the nurse about the importance of controlling blood glucose levels. The nurse should emphasize that uncontrolled blood glucose can lead to:

• A. Increased risk of heart disease and stroke.
• B. Improved wound healing.
• C. Reduced need for medication.
• D. Decreased risk of infection.

Correct answer: A

Rationale: The correct answer is A: Increased risk of heart disease and stroke. Uncontrolled blood glucose levels in clients with diabetes mellitus (DM) can lead to cardiovascular complications, such as heart disease and stroke. High blood glucose levels can damage blood vessels over time, increasing the risk of atherosclerosis and cardiovascular events. Choices B, C, and D are incorrect because uncontrolled blood glucose levels do not improve wound healing, reduce the need for medication, or decrease the risk of infection. In fact, uncontrolled blood glucose levels can impair wound healing, require more medications to manage symptoms, and increase the risk of infections due to compromised immune function.

4. A client with type 1 diabetes mellitus is admitted to the hospital with diabetic ketoacidosis (DKA). Which of the following interventions should the nurse implement first?

• A. Administer intravenous insulin
• B. Start an intravenous line and infuse normal saline
• C. Monitor serum potassium levels
• D. Obtain an arterial blood gas (ABG)

Correct answer: B

Rationale: The correct first intervention in the treatment of a client with diabetic ketoacidosis (DKA) is to start an intravenous line and infuse normal saline. This is essential for fluid resuscitation to restore intravascular volume and improve perfusion. Administering intravenous insulin can lead to further potassium depletion without first addressing dehydration and electrolyte imbalances. Monitoring serum potassium levels is important but should follow fluid resuscitation to avoid life-threatening hypokalemia. Obtaining an arterial blood gas (ABG) is necessary to assess the acid-base status but is not the initial priority when managing DKA.

5. Which instruction about insulin administration should Nurse Kate give to a client?

• A. Always follow the same order when drawing up different insulins into the syringe.
• B. Shake the vials before withdrawing the insulin.
• C. Store unopened vials of insulin in the refrigerator at recommended temperatures.
• D. Discard the intermediate-acting insulin if it appears cloudy.

Correct answer: A

Rationale: The correct answer is A. Consistently following the same order when drawing up different insulins helps to prevent medication errors. Option B is incorrect because shaking insulin vials could cause bubbles to form, leading to inaccurate dosing. Option C is incorrect as insulin should be stored in the refrigerator, not the freezer, to maintain its effectiveness. Option D is incorrect because cloudy appearance in intermediate-acting insulin may indicate the presence of insulin crystals, which can affect its potency, but this does not necessarily mean it should be discarded without consulting a healthcare provider.

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