Nursing Elites

1. In order to assist an older diabetic patient to engage in moderate daily exercise, which action is most important for the nurse to take?

• A. Determine what type of activities the patient enjoys.
• B. Remind the patient that exercise will improve self-esteem.
• C. Teach the patient about the effects of exercise on glucose levels.
• D. Give the patient a list of activities that are moderate in intensity.

Correct answer: A

Rationale: The correct answer is to determine what type of activities the patient enjoys. This approach is crucial as it helps in personalizing the exercise plan to the patient's preferences, making it more likely for them to adhere to it. Choice B is incorrect because focusing on self-esteem may not directly motivate the patient to engage in exercise. Choice C, although important, may not be the initial step as understanding the patient's preferences comes first. Choice D limits the patient's autonomy by not involving them in the decision-making process.

2. A 28-year-old male patient with type 1 diabetes reports how he manages his exercise and glucose control. Which behavior indicates that the nurse should implement additional teaching?

• A. The patient always carries hard candies when engaging in exercise.
• B. The patient goes for a vigorous walk when his glucose is 200 mg/dL.
• C. The patient has a peanut butter sandwich before going for a bicycle ride.
• D. The patient increases daily exercise when ketones are present in the urine.

Correct answer: D

Rationale: The correct answer is D because increasing exercise when ketones are present in the urine is inappropriate and potentially dangerous for a patient with type 1 diabetes. This behavior can worsen the ketosis and lead to further complications. Choices A, B, and C demonstrate appropriate self-management strategies for a patient with type 1 diabetes. Carrying hard candies during exercise can help prevent hypoglycemia, going for a walk with a glucose level of 200 mg/dL can help lower blood sugar, and having a snack before physical activity can provide necessary energy.

3. Which statement to a patient newly diagnosed with type 2 diabetes is correct?

• A. Complications of type 2 diabetes are less serious than those of type 1 diabetes.
• B. Insulin is not used to control blood glucose in patients with type 2 diabetes.
• C. Changes in diet and exercise may control blood glucose levels in type 2 diabetes.
• D. Type 2 diabetes is usually diagnosed when the patient is admitted with a hyperglycemic coma.

Correct answer: C

Rationale: Choice C is the correct statement to convey to a patient newly diagnosed with type 2 diabetes. Lifestyle modifications, such as changes in diet and exercise, are essential components of managing type 2 diabetes. These changes can help control blood glucose levels and improve overall health. Options A, B, and D are incorrect statements. While complications of type 2 diabetes can be serious, they are different from those of type 1 diabetes. Some patients with type 2 diabetes may require insulin therapy, but it is not true that insulin is not used at all. Type 2 diabetes is not typically diagnosed during a hyperglycemic coma, as it is usually identified through routine screenings or symptoms unrelated to a coma.

4. Which of the following is a recommendation for avoiding charges of negligence and false imprisonment for confused clients?

• A. Carefully assess and document client status.
• B. Ensure all patient information is logged out and the nurse has signed out of the computer before leaving the computer station.
• C. Keep careful notes while providing care to ensure accurate documentation later in the day.
• D. Discuss safety needs with clients.

Correct answer: A

Rationale: The correct answer is A: Carefully assess and document client status. By carefully assessing and documenting the client's status, healthcare providers can ensure they have a clear understanding of the client's condition, needs, and any potential risks. This helps in providing appropriate care and avoiding situations that may lead to charges of negligence or false imprisonment. Choice B is incorrect because logging out of computer systems is more related to data security and confidentiality rather than preventing negligence or false imprisonment. Choice C is not directly related to avoiding charges of negligence and false imprisonment but rather ensuring accurate documentation. Choice D, while important for overall client safety, does not specifically address the issue of avoiding charges of negligence and false imprisonment for confused clients.

5. What is the role of a nurse in a multidisciplinary team (MDT)?

• A. To lead the MDT
• B. To provide emotional support
• C. To advocate for patient needs
• D. To conduct clinical research

Correct answer: C

Rationale: In a multidisciplinary team (MDT), a nurse's role is to advocate for patient needs and ensure their perspectives are considered in the care plan. While leadership may be a part of a nurse's role in some settings, the primary focus in an MDT is collaboration and coordination. Providing emotional support is essential but may not be the primary role of a nurse in an MDT. Conducting clinical research is typically not a direct responsibility of a nurse in an MDT focused on patient care.

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