Nursing Elites

1. A nurse is teaching about foot care to a client who has diabetes mellitus (DM). What statement indicates understanding?

• A. I should wear my slippers whenever I am out of bed
• B. I can walk barefoot at home
• C. I should apply lotion between my toes
• D. I can soak my feet in warm water

Correct answer: A

Rationale: The correct answer is A. Wearing slippers or shoes when out of bed is crucial for clients with diabetes as it protects the feet from injury. Walking barefoot, as mentioned in option B, can increase the risk of cuts, sores, and infections in diabetic patients. Applying lotion between the toes, as stated in option C, can lead to maceration and increase the risk of fungal infections. Similarly, soaking feet in warm water, as mentioned in option D, can cause skin breakdown and should be avoided by diabetic patients.

2. A nurse is planning a staff education program to review nursing interventions for patients who have kidney failure. What source should the nurse identify as the best source for obtaining evidence-based practice information?

• A. A recent peer-reviewed nursing research article
• B. A website for a nursing association
• C. A textbook published 5 years ago
• D. An expert opinion from a seasoned nurse

Correct answer: A

Rationale: The correct answer is A: A recent peer-reviewed nursing research article. Peer-reviewed research articles provide the most current and reliable evidence-based practice information for clinical care. Choice B, a website for a nursing association, may have valuable information but may not always guarantee the highest level of evidence. Choice C, a textbook published 5 years ago, may not reflect the most up-to-date practices and guidelines. Choice D, an expert opinion from a seasoned nurse, though valuable, is not as reliable as evidence derived from peer-reviewed research articles.

3. A nurse is reviewing psychosocial stages of development for a school-age child. What would be an expected behavioral finding for this child?

• A. Personalize values and beliefs and base reasoning on ethical fairness principles.
• B. Develop a sense of personal identity that is influenced by family expectations.
• C. Develop a sense of industry through advances in learning.
• D. Take on new experiences and when unable to accomplish tasks, may feel guilty.

Correct answer: C

Rationale: The correct answer is C. School-age children (6-12 years) are in Erikson's stage of industry vs. inferiority. During this stage, they strive to develop a sense of industry through learning and socialization. They seek to excel in various areas, such as schoolwork or activities, and look for approval from peers and adults. Choices A, B, and D are incorrect because personalizing values and beliefs, developing personal identity influenced by family expectations, and feeling guilty for inability to accomplish tasks are not typical behavioral findings for a school-age child in the context of psychosocial development.

4. A client has been prescribed metoclopramide. Which of the following should the nurse include in client education regarding this medication?

• A. Notify your provider if you experience restlessness or spasms of the face or neck.
• B. Take the medication only if you feel nauseous.
• C. Avoid drinking any fluids while taking this medication.
• D. Take the medication on an empty stomach.

Correct answer: A

Rationale: The correct answer is A: 'Notify your provider if you experience restlessness or spasms of the face or neck.' Metoclopramide can cause extrapyramidal symptoms, such as restlessness and muscle spasms, particularly of the face and neck. These symptoms should be reported to the provider immediately. Choice B is incorrect because metoclopramide is not meant to be taken only when feeling nauseous; it is used to treat nausea and vomiting. Choice C is incorrect because it is important to stay hydrated while taking metoclopramide. Choice D is incorrect because metoclopramide is usually taken before meals to improve gastric emptying, not necessarily on an empty stomach.

5. A healthcare provider is caring for a patient and realizes they administered the wrong medication. What action should the healthcare provider take first?

• A. Notify the provider.
• B. Report the incident to the risk manager.
• C. Check the condition of the patient.
• D. Complete an incident report.

Correct answer: C

Rationale: The healthcare provider should first assess the patient to determine if any harm has occurred as a result of the medication error. Checking the patient's condition takes precedence as it allows for immediate intervention if necessary. Notifying the provider (choice A) can come later once the patient's condition is assessed. Reporting to the risk manager (choice B) and completing an incident report (choice D) are important steps but should follow the initial assessment of the patient to ensure timely and appropriate actions are taken.

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