dr shrunk orders intravenous iv insulin for rita a client with a blood sugar of 563 nurse aj administers insulin lispro humalog intravenously iv what

HESI LPN

HESI Leadership and Management Test Bank

1. Dr. Shrunk orders intravenous (IV) insulin for Rita, a client with a blood sugar of 563. Nurse AJ administers insulin lispro (Humalog) intravenously (IV). What does the best evaluation of the nurse reveal? Select one that does not apply.

A. The nurse could have given the insulin subcutaneously.
B. The nurse did not have to contact the physician.
C. The nurse should have used regular insulin (Humulin R).
D. The nurse used the correct insulin.

Correct answer: C

Rationale: The best evaluation of the nurse reveals that she should have used regular insulin (Humulin R) for IV administration. Regular insulin is the only insulin approved for intravenous administration due to its pharmacokinetic properties. Insulin lispro (Humalog) is not suitable for IV use. Choice A is incorrect because giving insulin intravenously is necessary in this case of high blood sugar. Choice B is incorrect because administering a different insulin without consulting the physician is not appropriate. Choice D is incorrect because the nurse used the incorrect insulin, which could pose risks to the client's health.

2. What is the main purpose of quality improvement in healthcare?

A. To increase healthcare costs
B. To improve patient outcomes
C. To decrease patient satisfaction
D. To increase hospital stays

Correct answer: B

Rationale: The main purpose of quality improvement in healthcare is to improve patient outcomes by enhancing the quality and safety of healthcare services. Choice A is incorrect because the goal is not to increase healthcare costs but to optimize resources and provide cost-effective care. Choice C is incorrect as the aim is to increase patient satisfaction through better outcomes. Choice D is incorrect as the objective is to reduce hospital stays by improving care efficiency and effectiveness.

3. You are working on a pediatric unit. Which toy or other diversional item or activity is most appropriate for your 18-month-old patient?

A. Story books
B. Beach balls
C. An interactive play session with other children less than 2 years of age
D. Pickup sticks

Correct answer: B

Rationale: A beach ball is appropriate for an 18-month-old as it is safe and can help with motor skills development. Choice A, storybooks, may not be suitable for this age group due to limited attention span. Choice C involves interaction with other children which may not always be feasible in a healthcare setting. Choice D, pickup sticks, poses a choking hazard and is not suitable for toddlers.

4. A client is in DKA, secondary to infection. As the condition progresses, which of the following symptoms might the nurse see?

A. Kussmaul's respirations and a fruity odor on the breath
B. Shallow respirations and severe abdominal pain
C. Decreased respirations and increased urine output
D. Cheyne-Stokes respirations and foul-smelling urine

Correct answer: A

Rationale: In diabetic ketoacidosis (DKA), as the condition progresses, the body tries to compensate for the acidic environment by increasing the respiratory rate, leading to Kussmaul's respirations. The accumulation of ketones in the body causes a fruity odor on the breath. Option A is correct because Kussmaul's respirations and a fruity odor on the breath are classic signs of DKA. Option B is incorrect because shallow respirations are not typically seen in DKA, and severe abdominal pain is more commonly associated with conditions like pancreatitis. Option C is incorrect as decreased respirations are not a typical finding in DKA, and increased urine output is more commonly seen in conditions like diabetes insipidus. Option D is incorrect because Cheyne-Stokes respirations are not characteristic of DKA, and foul-smelling urine is not a prominent symptom in this condition.

5. Which of the following chronic complications is associated with diabetes?

A. Dizziness, dyspnea on exertion, and coronary artery disease.
B. Retinopathy, neuropathy, and coronary artery disease.
C. Leg ulcers, cerebral ischemic events, and pulmonary infarcts.
D. Fatigue, nausea, vomiting, muscle weakness, and cardiac arrhythmias.

Correct answer: B

Rationale: The correct answer is B. Diabetes is associated with chronic complications such as retinopathy, neuropathy, and coronary artery disease. Choice A includes symptoms rather than chronic complications of diabetes. Choice C lists conditions not typically associated with diabetes. Choice D describes symptoms that may occur in various medical conditions but are not specific chronic complications of diabetes.