Nursing Elites

1. Nurse Kate is providing dietary instructions to a male client with hypoglycemia. To control hypoglycemic episodes, the nurse should recommend:

• A. Increasing saturated fat intake and fasting in the afternoon
• B. Increasing intake of vitamins B and D and taking iron supplements
• C. Eating a candy bar if lightheadedness occurs
• D. Consuming a low-carbohydrate, high-protein diet and avoiding fasting

Correct answer: D

Rationale: A low-carbohydrate, high-protein diet is beneficial for individuals with hypoglycemia as it helps in maintaining stable blood sugar levels. Choice A is incorrect as increasing saturated fat intake and fasting can worsen hypoglycemia. Choice B is incorrect as vitamins and iron supplements do not directly address hypoglycemia. Choice C is incorrect as consuming a candy bar may provide temporary relief but does not address the underlying cause of hypoglycemia.

2. When assessing a male client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamines, Nurse April is most likely to detect:

• A. A blood pressure of 130/70 mm Hg
• B. A blood glucose level of 130 mg/dl
• C. Bradycardia
• D. A blood pressure of 176/88 mm Hg

Correct answer: D

Rationale: Pheochromocytoma is a tumor of the adrenal medulla that secretes excessive catecholamines, leading to symptoms such as hypertension. The normal blood pressure range is around 120/80 mm Hg, so a blood pressure reading of 176/88 mm Hg is most likely to be detected in a client with pheochromocytoma. Choices A, B, and C are incorrect because pheochromocytoma typically presents with hypertension, not a normal or low blood pressure (choice A), not related to blood glucose levels (choice B), and not bradycardia (choice C).

3. Which of the following actions by the healthcare provider would be considered false imprisonment?

• A. The healthcare provider tells the client they are not allowed to leave until the physician has released them.
• B. The healthcare provider asks the client why they wish to leave.
• C. The healthcare provider asks the client to explain what they understand about their medical diagnosis.
• D. The healthcare provider asks the client to sign an against medical advice discharge form.

Correct answer: A

Rationale: The correct answer is A. False imprisonment occurs when a healthcare provider restrains a client from leaving against their will, even if the provider believes it is in the client's best interest. In this scenario, telling the client they are not allowed to leave until the physician has released them constitutes false imprisonment as it restricts the client's freedom of movement. Choice B is incorrect because asking the client why they wish to leave is a form of assessment and does not involve restraining the client. Choice C is incorrect as it pertains to educating the client about their medical condition. Choice D is incorrect because asking the client to sign an against medical advice discharge form is a legal and ethical procedure to ensure the client understands the risks of leaving against medical advice.

4. A nurse is preparing to administer insulin to a client with DM. The nurse understands that the peak time for rapid-acting insulin, such as lispro (Humalog), is:

• A. 30 minutes to 1 hour after administration.
• B. 1 to 2 hours after administration.
• C. 2 to 4 hours after administration.
• D. 3 to 5 hours after administration.

Correct answer: A

Rationale: The correct answer is A: 30 minutes to 1 hour after administration. Rapid-acting insulins like lispro, such as Humalog, peak quickly within 30 minutes to 1 hour after administration. This peak time is crucial to monitor for potential hypoglycemia, which is most likely to occur during this period. Choice B is incorrect as it suggests a longer peak time for rapid-acting insulin, which is inaccurate. Choices C and D are also incorrect because they indicate even longer peak times, which do not align with the rapid onset and peak action of lispro insulin.

5. The client with hypothyroidism is being educated by the healthcare provider about taking levothyroxine. Which of the following instructions should be included?

• A. Take the medication with meals
• B. Take the medication at bedtime
• C. Take the medication on an empty stomach in the morning
• D. Take the medication with a glass of milk

Correct answer: C

Rationale: The correct answer is to take levothyroxine on an empty stomach in the morning. This instruction is essential to enhance absorption and efficacy of the medication. Taking levothyroxine with meals, at bedtime, or with a glass of milk can interfere with its absorption and effectiveness, leading to suboptimal treatment outcomes.

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