Nursing Elites

1. Albert, a 35-year-old insulin-dependent diabetic, is admitted to the hospital with a diagnosis of pneumonia. He has been febrile since admission. His daily insulin requirement is 24 units of NPH. Every morning Albert is given NPH insulin at 0730. Meals are served at 0830, 1230, and 1830. The nurse expects that the NPH insulin will reach its maximum effect (peak) between the hours of:

• A. 1130 and 1330.
• B. 1330 and 1930.
• C. 1530 and 2130.
• D. 1730 and 2330.

Correct answer: C

Rationale: NPH insulin typically peaks 4-12 hours after administration, so a peak between 1530 and 2130 would be expected. Choice A (1130 and 1330) is too early for the peak effect of NPH insulin. Choice B (1330 and 1930) falls within the possible peak period but is not as accurate as choice C. Choice D (1730 and 2330) is too late for the peak effect of NPH insulin based on the typical peak timing.

2. Which of the following is a primary goal of nursing?

• A. Assist patients in achieving a peaceful death.
• B. Enhance personal knowledge and skills to improve patient outcomes.
• C. Champion quality of life over quantity of life.
• D. Manage costs to enhance patients' quality of life.

Correct answer: A

Rationale: The primary goal of nursing is to assist patients in achieving a peaceful death if recovery is not feasible. This involves providing comfort, dignity, and support during the end-of-life process. Choice B is incorrect because while improving personal knowledge and skills is important, it is not the primary goal of nursing. Choice C, advocating for quality of life over quantity of life, is a valid aspect of nursing care but may not always be the primary goal. Choice D, managing costs to enhance patients' quality of life, is not a primary goal of nursing, as the focus should primarily be on patient care and well-being, rather than financial considerations.

3. The client with DM who is taking insulin develops a fever and becomes confused. Which action should the nurse take first?

• A. Check the client's blood glucose level.
• B. Administer a fever-reducing medication.
• C. Give the client fluids to drink.
• D. Notify the health care provider.

Correct answer: A

Rationale: In a client with diabetes mellitus (DM) taking insulin, the development of fever and confusion may indicate hyperglycemia or diabetic ketoacidosis. Checking the blood glucose level is the priority action in this situation. This will help determine if the symptoms are related to high blood sugar levels, guiding further interventions. Administering a fever-reducing medication (choice B) addresses only the symptom of fever and does not address the underlying cause. Providing fluids to drink (choice C) is important but should come after addressing the potential hyperglycemia or diabetic ketoacidosis. Notifying the health care provider (choice D) can be important, but immediate action to evaluate and manage the client's condition should precede contacting the provider.

4. A nurse manager in the emergency department considers policy changes in the organization and changes in the community, and tries to predict how these may impact the functioning of the unit. Which of the following decisional activities best describes this manager's actions?

• A. Resource allocation
• B. Monitoring
• C. Job analysis and redesign
• D. Planning for the future

Correct answer: D

Rationale: The correct answer is 'Planning for the future.' In this scenario, the nurse manager is engaging in strategic planning by considering policy changes and community dynamics to forecast potential impacts on the unit's functioning. This decisional activity involves anticipating future changes, challenges, and opportunities, and preparing the unit to adapt accordingly. Choice A, 'Resource allocation,' involves distributing resources effectively to support daily operations, which is not the primary focus of the nurse manager's actions described. Choice B, 'Monitoring,' typically involves overseeing current activities and performance to ensure adherence to standards and goals, rather than proactively planning for future changes as the nurse manager is doing. Choice C, 'Job analysis and redesign,' pertains to evaluating and modifying job roles and responsibilities within the unit, which is not directly related to the strategic forecasting and planning involved in anticipating organizational and community impacts.

5. A client with Addison's disease is receiving corticosteroid therapy. The nurse should monitor for which of the following potential side effects?

• A. Hypoglycemia
• B. Hyperkalemia
• C. Hyperglycemia
• D. Hyponatremia

Correct answer: C

Rationale: The correct answer is C, Hyperglycemia. Corticosteroid therapy can lead to hyperglycemia by increasing blood glucose levels. Corticosteroids can induce insulin resistance, decrease glucose uptake by tissues, and promote gluconeogenesis. While corticosteroid therapy can cause hypoglycemia in some cases, it is more commonly associated with hyperglycemia. Hyperkalemia (choice B) is more commonly associated with conditions like renal failure or certain medications. Hyponatremia (choice D) is typically not a common side effect of corticosteroid therapy unless there are other contributing factors present.

Similar Questions