Nursing Elites

1. A nurse is preparing discharge information for a client who has type 2 diabetes mellitus. Which resource should the nurse provide?

• A. Personal blogs about managing diabetes medications.
• B. Food exchange lists for meal planning from the American Diabetes Association.
• C. Diabetes medication information from the Physicians' Desk Reference.
• D. Food label recommendations from the Institute of Medicine.

Correct answer: B

Rationale: The correct answer is B: Food exchange lists for meal planning from the American Diabetes Association. Food exchange lists provide structured meal planning for individuals with diabetes, helping them make healthier food choices and manage their condition effectively. Choice A is incorrect because personal blogs may not provide accurate and reliable information on managing diabetes and medications. Choice C is incorrect as diabetes medication information may not be directly related to meal planning and dietary management. Choice D is incorrect because food label recommendations from the Institute of Medicine may not specifically cater to the dietary needs and meal planning guidelines recommended for individuals with diabetes.

2. A nurse is providing teaching about folic acid to a client who is primigravida. Which of the following information should the nurse include in the teaching?

• A. You should take folic acid to prevent neural tube defects in your baby.
• B. You should consume at least 400 micrograms of folic acid daily.
• C. You can increase your dietary intake of folic acid by consuming cereals and citrus fruits.
• D. You should expect improved energy levels when taking folic acid supplements.

Correct answer: C

Rationale: The correct answer is C. Folic acid helps prevent neural tube defects, and dietary sources like cereals and citrus fruits are good options to increase folic acid intake. Choice A is incorrect because folic acid is primarily recommended to prevent neural tube defects, not to prevent infections. Choice B is incorrect because the recommended daily intake of folic acid for pregnant women is at least 400 micrograms, not 300. Choice D is incorrect because folic acid is not typically associated with improving energy levels.

3. A nurse manager is planning to promote client advocacy among staff in a medical unit. Which of the following actions should the nurse take?

• A. Encourage staff to implement the principle of paternalism when a client is having difficulty making a choice
• B. Tell staff to explain procedures to clients before obtaining informed consent
• C. Instruct unit staff to share personal experiences to help clients make decisions
• D. Develop a system for staff members to report safety concerns in the client care environment

Correct answer: D

Rationale: The correct answer is D. Developing a system for staff members to report safety concerns in the client care environment is crucial to promoting client advocacy and ensuring client safety. This action empowers staff to identify and address potential safety issues, ultimately enhancing the quality of care provided. Choices A, B, and C are incorrect. Choice A suggests implementing paternalism, which involves making decisions for clients without their input, contradicting the principles of client advocacy. Choice B focuses on informed consent procedures, which are important but do not directly relate to promoting client advocacy among staff. Choice C, sharing personal experiences, may not always align with professional boundaries and can potentially bias clients' decision-making processes.

4. A nurse is caring for a client who is receiving TPN. Which of the following actions should the nurse take to prevent infection?

• A. Change the TPN tubing every 72 hours.
• B. Monitor the client's blood glucose every 4 hours.
• C. Monitor the client's urine output every 8 hours.
• D. Use sterile technique when changing the central line dressing.

Correct answer: D

Rationale: The correct answer is D: 'Use sterile technique when changing the central line dressing.' When caring for a client receiving TPN, it is crucial to maintain aseptic technique to prevent infections. Changing the central line dressing with sterile technique helps reduce the risk of introducing pathogens into the client's system. Choices A, B, and C are incorrect because changing the TPN tubing every 72 hours, monitoring blood glucose, and monitoring urine output are important aspects of care but are not directly related to preventing infection in clients receiving TPN.

5. A nurse is planning care for a client who is experiencing acute mania. What intervention should the nurse include?

• A. Encourage the client to take frequent rest periods.
• B. Withdraw TV privileges if the client does not attend group therapy.
• C. Place the client in seclusion during periods of anxiety.
• D. Encourage the client to spend time in the day room.

Correct answer: A

Rationale: The correct answer is A: Encourage the client to take frequent rest periods. During acute mania, individuals often experience high levels of energy, decreased need for sleep, and increased activity levels. Encouraging the client to take frequent rest periods can help prevent exhaustion and promote better self-regulation. Choice B is incorrect because withdrawing TV privileges may not be directly related to managing acute mania. Choice C is incorrect as placing the client in seclusion can exacerbate feelings of anxiety and agitation. Choice D is incorrect as spending time in the day room may not address the need for rest and relaxation that is crucial during acute mania.

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