Nursing Elites

1. What is the primary action of amlodipine when prescribed to a patient with hypertension?

• A. Increase heart rate
• B. Reduce blood pressure
• C. Lower cholesterol levels
• D. Decrease blood sugar levels

Correct answer: B

Rationale: Amlodipine is a calcium channel blocker that works by relaxing the blood vessels, leading to a reduction in blood pressure. This medication does not increase heart rate, lower cholesterol levels, or decrease blood sugar levels.

2. A 34-year-old woman presents with intermittent abdominal pain, bloating, and diarrhea. She notes that her symptoms improve with fasting. She has a history of iron deficiency anemia. What is the most likely diagnosis?

• A. Irritable bowel syndrome
• B. Celiac disease
• C. Lactose intolerance
• D. Crohn's disease

Correct answer: B

Rationale: The patient's symptoms of intermittent abdominal pain, bloating, and diarrhea that improve with fasting, along with a history of iron deficiency anemia, are highly suggestive of celiac disease. In celiac disease, gluten ingestion leads to mucosal damage in the small intestine, causing malabsorption of nutrients like iron, leading to anemia. The improvement of symptoms with fasting can be explained by the temporary avoidance of gluten-containing foods. Irritable bowel syndrome typically does not improve with fasting. Lactose intolerance usually presents with symptoms after dairy consumption, not with fasting. Crohn's disease typically presents with more chronic symptoms and is not commonly associated with improvement on fasting.

3. A patient with type 1 diabetes mellitus is admitted to the hospital with diabetic ketoacidosis (DKA). What is the priority nursing action?

• A. Administer regular insulin intravenously.
• B. Give oral hypoglycemic agents.
• C. Administer sodium bicarbonate.
• D. Provide a high-calorie diet.

Correct answer: A

Rationale: The priority nursing action for a patient with type 1 diabetes mellitus admitted with diabetic ketoacidosis (DKA) is to administer regular insulin intravenously. Insulin helps to lower blood glucose levels and correct acidosis, which are critical in managing DKA. Administering oral hypoglycemic agents is not appropriate in the acute setting of DKA as they may not work quickly enough compared to intravenous insulin. While sodium bicarbonate may be used to correct acidosis, insulin administration is the priority to address both hyperglycemia and acidosis simultaneously. Providing a high-calorie diet is not suitable initially in DKA management; the main focus is on stabilizing the patient's condition through insulin therapy and fluid/electrolyte correction.

4. A client with a history of diabetes mellitus presents with confusion, sweating, and palpitations. What should the nurse do first?

• A. Check the client's blood glucose level.
• B. Administer 10 units of insulin.
• C. Give the client a high-protein snack.
• D. Measure the client's blood pressure.

Correct answer: A

Rationale: The correct first action for a client presenting with confusion, sweating, and palpitations, suggestive of hypoglycemia, is to check the client's blood glucose level. This step helps to confirm if the symptoms are due to low blood sugar levels and guides appropriate interventions. Administering insulin without knowing the current blood glucose level can be dangerous and is not recommended as the initial step. Offering a high-protein snack may be necessary after confirming hypoglycemia, but checking the blood glucose level takes precedence. Measuring blood pressure is not the priority in this situation; addressing hypoglycemia is the immediate concern.

5. A client with diabetes has a new prescription for 14 units of regular insulin and 28 units of NPH insulin subcutaneously at breakfast daily. What is the total number of units of insulin that should be prepared in the insulin syringe?

• A. 42 units
• B. 14 units
• C. 28 units
• D. 32 units

Correct answer: A

Rationale: To calculate the total number of units of insulin, you need to add the 14 units of regular insulin to the 28 units of NPH insulin, which equals 42 units. Therefore, the nurse should prepare 42 units of insulin in the syringe for the client.

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