Nursing Elites

1. A nurse is providing teaching to an adolescent who has type 1 diabetes mellitus. Which of the following goals should the nurse include in the teaching?

• A. HbA1c level greater than 8%.
• B. Blood glucose level greater than 200 mg/dL at bedtime.
• C. Blood glucose level less than 60 mg/dL before breakfast.
• D. HbA1c level less than 7%.

Correct answer: D

Rationale: The correct answer is D. An HbA1c level less than 7% indicates good long-term glucose control for clients with diabetes. This goal reflects optimal glycemic control and reduces the risk of long-term complications. Choices A, B, and C are incorrect because they do not represent appropriate goals for managing type 1 diabetes in an adolescent. An HbA1c level greater than 8% (choice A) signifies poor glucose control, while a blood glucose level greater than 200 mg/dL at bedtime (choice B) and a blood glucose level less than 60 mg/dL before breakfast (choice C) are not within the target ranges for safe and effective diabetes management.

2. A nurse is observing an assistive personnel (AP) apply antiembolic stockings for a client. Which of the following actions by the AP demonstrates an understanding of how to perform this skill?

• A. Apply the stocking while the client is seated
• B. Apply the stocking before the client gets out of bed
• C. Use lotion under the stocking to ease application
• D. Bunch the stocking around the heel before applying

Correct answer: B

Rationale: The correct answer is B. Applying antiembolic stockings before the client gets out of bed is crucial as it helps prevent venous stasis and clot formation. Choice A is incorrect because stockings should be applied before the client gets out of bed. Choice C is incorrect as using lotion under the stocking can cause the stocking to slip. Choice D is incorrect because the stocking should be smooth and not bunched to prevent pressure points.

3. A nurse is planning discharge teaching about cord care for the parents of a newborn. Which of the following instructions should the nurse plan to include in the teaching?

• A. Clean the base of the cord with hydrogen peroxide daily.
• B. The cord stump will fall off in 5 days.
• C. Contact the provider if the cord stump turns black.
• D. Keep the cord stump dry until it falls off.

Correct answer: D

Rationale: The correct answer is to keep the cord stump dry until it falls off. This is important to promote natural healing and prevent infection. Choice A is incorrect because cleaning the cord with hydrogen peroxide daily can actually delay healing and increase the risk of infection. Choice B is incorrect as the cord stump typically falls off within 1 to 3 weeks, not in 5 days. Choice C is incorrect because a cord stump turning black is a normal part of the healing process and does not necessarily indicate a problem requiring immediate provider contact.

4. How should a healthcare provider respond to a patient experiencing acute chest pain?

• A. Administer prescribed nitroglycerin
• B. Provide oxygen
• C. Call for emergency assistance
• D. Reassure the patient

Correct answer: A

Rationale: In the case of a patient experiencing acute chest pain, the initial response should include administering prescribed nitroglycerin. Nitroglycerin helps dilate blood vessels and improve blood flow to the heart, which can be beneficial in managing chest pain related to cardiac issues. Providing oxygen can also be helpful to support oxygenation. However, the priority in this scenario is to address the potential cardiac cause by administering nitroglycerin. Calling for emergency assistance is crucial if the patient's condition does not improve or deteriorates. Reassuring the patient is essential for emotional support but should not be the primary intervention in the case of acute chest pain.

5. How should a healthcare professional manage a patient with diarrhea?

• A. Provide oral fluids and monitor stool consistency
• B. Administer antidiarrheal medications and monitor hydration
• C. Monitor for electrolyte imbalances and provide antibiotics
• D. Provide a low-fiber diet and monitor weight

Correct answer: A

Rationale: For a patient with diarrhea, the priority is to manage dehydration by providing oral fluids and monitoring stool consistency. Option B suggesting administering antidiarrheal medications is not recommended as it may prolong the infection by preventing the body from expelling the infectious agent. Option C is incorrect because antibiotics are not routinely indicated for diarrhea unless there is a specific bacterial infection. Option D is not the most appropriate initial intervention for managing diarrhea since a low-fiber diet may not provide adequate nutrition for the patient or help resolve the underlying cause of diarrhea.

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