Nursing Elites

1. A healthcare provider is reviewing laboratory results for a client who has diabetes mellitus. Which of the following tests is an indicator of long-term blood glucose control?

• A. Fasting blood glucose
• B. Glycosylated hemoglobin (HbA1c)
• C. Random blood glucose
• D. Postprandial blood glucose

Correct answer: B

Rationale: The correct answer is B, Glycosylated hemoglobin (HbA1c). HbA1c provides a measure of long-term blood glucose control over the past 2-3 months. This test reflects the average blood glucose levels during this period, making it a valuable tool in managing diabetes. Choices A, C, and D are not indicators of long-term blood glucose control. Fasting blood glucose measures the current glucose level after a period of not eating, random blood glucose provides a snapshot of the current glucose level, and postprandial blood glucose measures the glucose level after a meal.

2. A client with a new prescription for levothyroxine is receiving discharge teaching. Which of the following client statements indicates an understanding of the teaching?

• A. I should take this medication with food to prevent nausea.
• B. I will take this medication every morning before breakfast.
• C. I will stop taking this medication if I experience chest pain.
• D. I will take this medication at bedtime.

Correct answer: B

Rationale: The correct answer is B. Levothyroxine should be taken every morning before breakfast to enhance absorption and maintain consistent thyroid hormone levels. Option A is incorrect because levothyroxine should be taken on an empty stomach. Option C is incorrect because chest pain is not a common side effect of levothyroxine and stopping the medication abruptly can be harmful. Option D is incorrect because taking levothyroxine at bedtime may result in decreased absorption due to interactions with food and other medications.

3. A nurse is preparing to administer vancomycin IV to a client who has methicillin-resistant Staphylococcus aureus (MRSA). Which of the following actions should the nurse take?

• A. Administer the medication over 60 minutes
• B. Monitor the client's blood glucose level during administration
• C. Infuse the medication rapidly to reduce the risk of infection
• D. Administer the medication using a filter needle

Correct answer: A

Rationale: The correct action the nurse should take is to administer the medication over 60 minutes. This is important because administering vancomycin over 60 minutes helps prevent red man syndrome, a reaction that can occur with rapid infusion. Monitoring the client's blood glucose level (Choice B) is unrelated to vancomycin administration. Infusing the medication rapidly (Choice C) is incorrect and can lead to adverse reactions. Administering the medication using a filter needle (Choice D) is unnecessary for vancomycin administration.

4. A client is experiencing mild anxiety. Which of the following findings should the nurse expect?

• A. Feelings of dread
• B. Heightened perceptual field
• C. Rapid speech
• D. Purposeless activity

Correct answer: B

Rationale: In clients experiencing mild anxiety, a heightened perceptual field is a common finding. This means that the individual may be more alert and observant of their surroundings, sometimes to the point of being hyper-aware. Choices A, C, and D are less likely to be associated with mild anxiety. Feelings of dread (Choice A) are more commonly seen in moderate to severe anxiety. Rapid speech (Choice C) may be observed in some cases of anxiety, but it is not a specific hallmark of mild anxiety. Purposeless activity (Choice D) is more indicative of severe anxiety or other mental health conditions.

5. A nurse manager is updating protocols for the use of belt restraints. Which of the following guidelines should the nurse include?

• A. Remove the client's restraint every 4 hours.
• B. Document the client's condition every 15 minutes.
• C. Attach the restraint to the bed's side rails.
• D. Request a PRN restraint prescription for clients who are aggressive.

Correct answer: B

Rationale: The correct answer is B. When updating protocols for the use of belt restraints, it is essential to document the client's condition every 15 minutes. This frequent documentation helps ensure the client's safety and allows for timely assessment of the need for continued restraint use. Choice A is incorrect because restraints should be removed and reassessed more frequently than every 4 hours. Choice C is incorrect as restraints should not be attached to the bed's side rails due to entrapment risks. Choice D is also incorrect as restraints should not be used as needed (PRN) but rather based on a specific prescription and assessment indicating the need for restraint use.

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