Nursing Elites

1. A client with type 1 diabetes mellitus who jogs daily is being taught by a nurse about the preferred sites for insulin absorption. What is the most appropriate site for this client?

• A. Arms
• B. Legs
• C. Abdomen
• D. Iliac crest

Correct answer: C

Rationale: The abdomen is the most appropriate site for insulin absorption in a client who jogs. When a client is involved in physical activity like jogging, the abdomen is preferred as it provides more consistent absorption compared to the arms or legs, which can have altered absorption rates due to increased blood flow during exercise. The iliac crest is not a common site for insulin injections and may not provide optimal absorption rates compared to the abdomen.

2. When performing a health history on a patient who is to begin receiving a thiazide diuretic to treat heart failure, the nurse will be concerned about a history of which condition?

• A. Asthma
• B. Glaucoma
• C. Gout
• D. Hypertension

Correct answer: C

Rationale: Thiazide diuretics block uric acid secretion, leading to elevated levels that can contribute to gout. Therefore, patients with a history of gout should take thiazide diuretics with caution. Asthma (Choice A), Glaucoma (Choice B), and Hypertension (Choice D) are not directly contraindicated with thiazide diuretics, making choices A, B, and D incorrect.

3. A client has a serum potassium level of 6.5 mmol/L, a serum creatinine level of 2 mg/dL, and a urine output of 350 mL/day. What is the best action by the nurse?

• A. Place the client on a cardiac monitor immediately.
• B. Teach the client to limit high-potassium foods.
• C. Continue to monitor the client’s intake and output.
• D. Ask to have the laboratory redraw the blood specimen.

Correct answer: A

Rationale: The best immediate action by the nurse in this situation is to place the client on a cardiac monitor immediately. A serum potassium level of 6.5 mmol/L indicates hyperkalemia, which can lead to life-threatening dysrhythmias. Monitoring the cardiac status is crucial to detect any potential arrhythmias promptly. Teaching the client to limit high-potassium foods (Choice B) may be important for long-term management, but it is not the priority at this moment. Continuing to monitor intake and output (Choice C) is important for assessing renal function but does not address the immediate risk of dysrhythmias. Asking to have the laboratory redraw the blood specimen (Choice D) is unnecessary since the current results indicate a critical situation that requires immediate action.

4. The patient is taking hydrochlorothiazide (HydroDIURIL) and digoxin (Lanoxin). Which potential electrolyte imbalance will the nurse monitor for in this patient?

• A. Hypermagnesemia
• B. Hypernatremia
• C. Hypocalcemia
• D. Hypokalemia

Correct answer: D

Rationale: The correct answer is D: Hypokalemia. Thiazide diuretics like hydrochlorothiazide can cause hypokalemia. Hypokalemia enhances the effects of digoxin, leading to digoxin toxicity. Thiazides can also cause hypercalcemia. Choices A, B, and C are incorrect. Hypermagnesemia is not typically associated with hydrochlorothiazide use. Hypernatremia and hypocalcemia are not the primary electrolyte imbalances to monitor for in this scenario.

5. The nurse is collecting information from a client with chronic pancreatitis who reports persistent gnawing abdominal pain. To help the client manage the pain, which assessment data is most important for the nurse to obtain?

• A. Presence and activity of bowel sounds
• B. Color and consistency of feces
• C. Eating patterns and dietary intake
• D. Level and amount of physical activity

Correct answer: C

Rationale: In chronic pancreatitis, managing abdominal pain is crucial, and assessing the client's eating patterns and dietary intake is essential. Dietary modifications can help alleviate symptoms and reduce the workload on the pancreas. Choices A, B, and D are not directly related to pain management in chronic pancreatitis. Bowel sounds, fecal characteristics, and physical activity may provide important information in other conditions but are not the priority in this scenario.

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