Nursing Elites

1. The nurse is providing discharge teaching to a client with a new diagnosis of diabetes mellitus. Which statement by the client indicates a need for further teaching?

• A. I will need to monitor my blood sugar levels daily.
• B. I will follow a diet low in carbohydrates.
• C. I will rotate the injection sites for my insulin.
• D. I will exercise regularly to help manage my diabetes.

Correct answer: B

Rationale: The correct answer is B. The statement 'I will follow a diet low in carbohydrates' indicates a need for further teaching. In diabetes mellitus, it is essential to follow a balanced diet that includes carbohydrates, proteins, and fats. Carbohydrates are a major source of energy and should be included in moderation to help manage blood sugar levels. Monitoring blood sugar levels daily (A), rotating injection sites for insulin (C), and exercising regularly (D) are all appropriate self-management strategies for individuals with diabetes mellitus.

2. A client is suspected of being poisoned and presents with symmetric, descending flaccid paralysis, blurred vision, double vision, and dry mouth. The nurse should consider these findings consistent with which potential bioterrorism agent?

• A. ricin
• B. botulism toxin
• C. sulfur mustard
• D. yersinia pestis

Correct answer: B

Rationale: The correct answer is B: botulism toxin. The symptoms described, including symmetric, descending flaccid paralysis, blurred vision, double vision, and dry mouth, are classic manifestations of botulism, which is caused by a toxin produced by Clostridium botulinum. This toxin affects the nervous system, leading to muscle weakness and paralysis. Choice A, ricin, typically presents with gastrointestinal symptoms and organ failure. Choice C, sulfur mustard, causes blistering skin and respiratory issues. Choice D, yersinia pestis, is associated with the plague and presents with fever, chills, weakness, and swollen lymph nodes.

3. A nurse is planning a community health fair to promote cardiovascular health. Which activity should be included to best engage participants?

• A. free blood pressure screenings
• B. lectures on heart-healthy diets
• C. distribution of pamphlets on heart disease
• D. cooking demonstrations of healthy recipes

Correct answer: A

Rationale: Offering free blood pressure screenings should be included in the community health fair to best engage participants. This activity provides immediate, valuable information about participants' cardiovascular health. Blood pressure screenings are interactive, engaging, and offer personalized insights that can motivate individuals to take action towards improving their heart health. Lectures on heart-healthy diets, distribution of pamphlets, and cooking demonstrations, although beneficial, may not have the same level of immediate impact and engagement as the hands-on experience of getting one's blood pressure checked.

4. The nurse is caring for a client with hyperthyroidism. Which assessment finding requires immediate intervention?

• A. Heart rate of 100 beats per minute.
• B. Blood pressure of 150/90 mm Hg.
• C. Respiratory rate of 24 breaths per minute.
• D. Weight loss of 5 pounds in one week.

Correct answer: D

Rationale: Weight loss of 5 pounds in one week in a client with hyperthyroidism is concerning as it may indicate severe hypermetabolism, leading to potential complications such as cardiac arrhythmias, muscle weakness, and other metabolic disturbances. Rapid weight loss in hyperthyroidism indicates an accelerated metabolic rate and increased energy expenditure, which can be detrimental to the client's health. The other assessment findings (heart rate of 100 beats per minute, blood pressure of 150/90 mm Hg, respiratory rate of 24 breaths per minute) are commonly seen in clients with hyperthyroidism and may not necessarily require immediate intervention unless they are significantly outside the normal range or causing distress to the client.

5. The nurse is developing a workshop on cancer prevention for a group of adults at a wellness bar. Which recommendation should the nurse include in the workshop?

• A. Know the four warning signs of cancer
• B. Maintain a healthy weight and exercise regularly
• C. Refrain from alcohol
• D. Obtain at least 6 to 10 hours of sleep per night

Correct answer: B

Rationale: Maintaining a healthy weight and exercising regularly are crucial recommendations in cancer prevention. These habits help reduce the risk of developing cancer by promoting overall health and reducing factors associated with cancer development. Knowing the warning signs of cancer (Choice A) is important for early detection but does not directly prevent cancer. While refraining from alcohol (Choice C) is beneficial for some cancers, it is not as universally applicable as maintaining a healthy weight and exercising. Getting adequate sleep (Choice D) is essential for overall health but is not as directly linked to cancer prevention as maintaining a healthy weight and regular exercise.

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