Nursing Elites

1. A nurse is assessing a client's readiness to learn about insulin self-administration. Which of the following statements should the nurse identify as an indication that the client is ready to learn?

• A. "I can concentrate best in the morning."
• B. "It is difficult to read the instructions because my glasses are at home."
• C. "I'm wondering why I need to learn this."
• D. "You will have to talk to my partner about this."

Correct answer: D

Rationale: The correct answer is D, "You will have to talk to my partner about this." This response indicates that the client is willing to involve their partner in the learning process, showing readiness to take responsibility and engage in the education. Choices A, B, and C demonstrate potential barriers to learning: A indicates a preference for learning time but does not show active involvement, B focuses on external factors hindering learning, and C reflects a lack of understanding or motivation for the learning.

2. Which of the following is a key principle of team nursing?

• A. Decentralized decision making
• B. Centralized decision making
• C. Individual accountability
• D. Shared responsibility

Correct answer: D

Rationale: The correct answer is D: 'Shared responsibility.' Team nursing emphasizes shared responsibility among team members for patient care. This approach promotes collaboration and coordination among healthcare professionals to deliver comprehensive and holistic care. Choices A and B are incorrect because team nursing typically involves collaborative decision-making rather than centralized or decentralized decision-making. Choice C, 'Individual accountability,' does not align with the collaborative nature of team nursing, where responsibility is shared among team members rather than falling solely on individuals.

3. 1. To monitor for complications in a patient with type 2 diabetes, which tests will the nurse in the diabetic clinic schedule at least annually (select one that doesn't apply)?

• A. Blood pressure
• B. Serum creatinine
• C. Chest x-ray
• D. Urine for microalbuminuria

Correct answer: C

Rationale: The correct answer is C: Chest x-ray. While monitoring for complications in a patient with type 2 diabetes, annual tests such as blood pressure measurement, serum creatinine levels, and urine for microalbuminuria are essential. These tests help in assessing kidney function, cardiovascular health, and early signs of kidney damage, which are common complications of diabetes. A chest x-ray is not routinely scheduled annually to monitor for complications related to type 2 diabetes, making it the least applicable option.

4. Which of the following laws govern nursing practice?

• A. Statutory laws
• B. Common laws
• C. Administrative laws
• D. Constitutional laws

Correct answer: A

Rationale: Statutory laws govern nursing practice. These laws are enacted by legislative bodies and regulate various aspects of nursing practice, including licensure requirements, scope of practice, and patient care standards. Common laws, administrative laws, and constitutional laws may also impact nursing practice, but statutory laws specifically outline the legal framework for nursing professionals to follow. Common laws are based on court decisions and precedents, not specific to nursing practice. Administrative laws deal with regulations set by administrative agencies. Constitutional laws relate to the fundamental rights and principles outlined in the constitution, not specifically governing nursing practice.

5. During a physical assessment of adult clients, which of the following techniques should the nurse use?

• A. Use the Face, Legs, Activity, Cry, and Consolability (FLACC) pain rating scale for a client experiencing pain.
• B. Palpate the client's abdomen before auscultating bowel sounds.
• C. Ensure the bladder of the blood pressure cuff surrounds 80% of the client's arm.
• D. Obtain an apical heart rate by auscultating at the third intercostal space to the left of the sternum.

Correct answer: B

Rationale: When performing a physical assessment, it is essential to palpate the client's abdomen before auscultating bowel sounds. This sequence helps prevent altering bowel sound results due to the pressure applied during palpation. Choice A is incorrect because the FLACC pain rating scale is typically used for nonverbal or pediatric clients, not adults. Choice C is incorrect because the bladder of the blood pressure cuff should surround about 80% of the client's arm circumference, not the bladder of the cuff itself. Choice D is incorrect because to obtain an apical heart rate, auscultation should be done at the fifth intercostal space at the midclavicular line, not at the third intercostal space to the left of the sternum.

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