Nursing Elites

1. Mrs. G is seen for follow-up after testing for chronically high blood glucose levels. Her physician diagnoses her with type 1 diabetes. Which of the following information is part of this client's education about this condition?

• A. Type 1 diabetes occurs due to increased carbohydrate intake and lack of exercise
• B. Type 1 diabetes is managed through diet and exercise
• C. Type 1 diabetes is caused by destruction of beta cells in the pancreas
• D. Type 1 diabetes leads to the body's cells rejecting insulin

Correct answer: C

Rationale: Type 1 diabetes is an autoimmune condition where the immune system attacks and destroys the beta cells in the pancreas, leading to a lack of insulin production. Insulin is essential for regulating blood glucose levels and enabling cells to use glucose for energy. Understanding that type 1 diabetes results from the destruction of beta cells helps patients comprehend the need for insulin replacement therapy. Choices A and B are incorrect as type 1 diabetes is not primarily caused by diet or exercise habits. Choice D is incorrect because type 1 diabetes is not about the body's cells rejecting insulin but rather the lack of insulin production due to beta cell destruction.

2. What is a key principle of patient teaching that must take place to ensure patient safety?

• A. Family members should be present
• B. Teaching must be documented
• C. Understanding must be confirmed
• D. Teaching should be provided by multiple staff members

Correct answer: C

Rationale: A key principle of patient teaching that ensures patient safety is the confirmation of understanding. To ensure patient safety, it is crucial to confirm that the patient comprehends the information provided. This confirmation can be achieved by having the patient repeat back the information or demonstrate understanding through return demonstration. Documenting the patient's understanding is essential to track the effectiveness of the teaching session and ensure that the patient is equipped with the necessary knowledge for their safety. Family members being present or having multiple staff members provide teaching may be beneficial in certain situations, but the primary focus should be on confirming the patient's understanding to enhance safety and promote effective learning.

3. Because of budget cuts in the hospital, the nursing manager informs the staff that they must either rotate to other units more often or take their turns staying home from work. Which principle is this nurse manager demonstrating?

• A. Justice
• B. Paternalism
• C. Veracity
• D. Fraternity

Correct answer: D

Rationale: Veracity involves truth-telling, even in challenging situations. In this scenario, the nurse manager is being transparent about the need for staff to rotate units or take turns staying home due to budget cuts. This allows the staff to make informed decisions about their work schedules and potential impact on their pay and work areas. Option A, Justice, does not apply as the focus is on communication and transparency, not fairness. Option B, Paternalism, does not fit as it involves decisions made for others' well-being without their input, which is not the case here. Option D, Fraternity, pertains to unity among individuals, which is not the principle demonstrated by the nurse manager in this situation.

4. The key to the prevention of a pandemic influenza is:

• A. Early detection
• B. Early antibiotic treatment
• C. Vaccination of at-risk populations
• D. Isolation of suspected cases

Correct answer: A

Rationale: The key to preventing a pandemic influenza is early detection. Detecting influenza cases early allows for timely public health responses to limit the spread of the virus. Early detection helps in implementing measures such as isolation, treatment, and vaccination to prevent the development of a full-blown pandemic. Antibiotics are not effective against influenza viruses, so early antibiotic treatment is not the key to prevention. While vaccination of at-risk populations is important in controlling the spread of influenza, early detection is crucial as it allows for timely implementation of vaccination strategies. Isolation of suspected cases is a containment measure rather than a prevention strategy; the key to prevention lies in early detection to stop the spread before it becomes a pandemic.

5. A healthcare professional is preparing to draw a blood specimen from an adult client's central line. All of the following actions for this procedure are correct EXCEPT:

• A. Disconnect the current infusion
• B. Clean the cap with alcohol and attach a 5 cc syringe
• C. Draw 5 cc of a blood sample to discard
• D. Flush with saline after the sample

Correct answer: B

Rationale: When drawing a blood specimen from a central line, the healthcare professional should disconnect any infusions that are currently running and that could contaminate the specimen. It is important to use a minimum size of a 10 cc syringe when using a central line to avoid placing too much pressure on the catheter. Cleaning the cap with alcohol and attaching a 5 cc syringe is not appropriate as a larger syringe size should be used for this procedure. Drawing 5 cc of a blood sample to discard and flushing with saline after the sample are correct steps in the process of drawing a blood specimen from a central line.

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