Nursing Elites

1. A nurse is teaching an older adult client who has type 2 diabetes mellitus about how to care for corns and calluses on her toes. Which of the following statements by the client indicates an understanding of the teaching?

• A. I can place an oval corn pad over toes that have corns as long as I remove the pad weekly
• B. I should soak my feet in warm water daily to soften corns and calluses
• C. I can apply lotion to soften calluses as long as I don’t put lotion between my toes
• D. I should use an over the counter liquid medication to remove corns

Correct answer: C

Rationale: Applying lotion to the feet, avoiding between toes, is correct; over-the-counter treatments and soaking are not recommended.

2. The nurse is preparing to administer insulin to a client with type 1 diabetes. Which assessment finding would require the nurse to hold the insulin and contact the healthcare provider?

• A. Blood glucose of 100 mg/dL
• B. Client reports feeling shaky
• C. Client ate only half of breakfast
• D. Client is sweating

Correct answer: A

Rationale: A blood glucose of 100 mg/dL is relatively low for administering insulin, especially if the client has not eaten adequately; further assessment and contacting the provider are necessary. Hypoglycemia can be a serious concern when administering insulin, and a blood glucose level of 100 mg/dL indicates a risk of hypoglycemia. Holding the insulin and contacting the healthcare provider is crucial to prevent hypoglycemia-related complications. Choices B, C, and D are not immediate concerns for holding insulin as they do not directly indicate a risk of hypoglycemic events.

3. A client with a history of heart failure is admitted with weight gain and peripheral edema. Which medication should the LPN/LVN anticipate being prescribed?

• A. Lisinopril (Zestril)
• B. Furosemide (Lasix)
• C. Metoprolol (Lopressor)
• D. Simvastatin (Zocor)

Correct answer: B

Rationale: Furosemide (Lasix) is the correct answer. In a client with heart failure experiencing weight gain and peripheral edema, the priority is to manage fluid overload. Furosemide is a loop diuretic commonly prescribed to reduce excess fluid in heart failure patients. Lisinopril (Zestril) is an ACE inhibitor used to treat hypertension and heart failure but does not directly address fluid overload. Metoprolol (Lopressor) is a beta-blocker that helps manage heart failure symptoms but does not primarily target fluid retention. Simvastatin (Zocor) is a statin used to lower cholesterol levels and is not indicated for managing fluid overload in heart failure.

4. The nurse is preparing the teaching plan for a group of parents about risks to toddlers. The nurse plans to explain proper communication in the event of accidental poisoning. The nurse should plan to tell the parents to first state what substance was ingested and then what information should be the priority for the parents to communicate?

• A. The parents' name and telephone number
• B. The currency of the immunization and allergy history of the child
• C. The estimated time of the accidental poisoning and a confirmation that the parents will bring the containers of the ingested substance
• D. The affected child's age and weight

Correct answer: D

Rationale: In the event of accidental poisoning, it is crucial to know the child's age and weight to determine the appropriate treatment. This information helps healthcare providers calculate the correct dosage of antidotes or medications needed based on the child's size and age. The child's age and weight play a significant role in managing accidental poisoning cases. Therefore, this information should be a priority for parents to communicate in such emergencies. Choices A, B, and C are not as critical as the child's age and weight when it comes to immediate treatment decisions for accidental poisoning.

5. At 0100 on a male client's second postoperative night, the client states he is unable to sleep and plans to read until feeling sleepy. What action should the nurse implement?

• A. Stay with the client and offer assistance with relaxation techniques
• B. Assess the client's pain level and administer pain medication if needed
• C. Bring the client a prescribed PRN sedative-hypnotic
• D. Encourage the client to engage in a quiet, non-stimulating activity until feeling sleepy

Correct answer: C

Rationale: At 0100 on the client's second postoperative night, the nurse should address the client's inability to sleep. Providing a prescribed PRN sedative-hypnotic is appropriate in this situation to help the client rest. Choice A is incorrect because leaving the room and closing the door does not directly address the client's sleep concern. Choice B is not the priority at this moment since the client's main issue is insomnia, not pain. Choice D, while encouraging a non-stimulating activity, does not provide immediate relief for the client's sleeplessness as a sedative-hypnotic would.

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