Nursing Elites

1. The client with newly diagnosed type 1 diabetes mellitus is being taught about insulin administration by the nurse. Which statement indicates that the client needs further teaching?

• A. I will inject my insulin into my abdomen for the fastest absorption.
• B. I will rotate injection sites to prevent lipodystrophy.
• C. I will store my insulin in the refrigerator at all times.
• D. I will rotate injection sites to prevent lipodystrophy.

Correct answer: C

Rationale: The correct answer is C. Insulin should not be stored in the refrigerator at all times; it should be kept at room temperature when in use to avoid irritation at the injection site. Storing insulin in the refrigerator can cause it to thicken and may lead to discomfort upon injection. Choices A and D are correct statements as injecting insulin into the abdomen for faster absorption and rotating injection sites to prevent lipodystrophy are appropriate insulin administration techniques. Therefore, the client does not need further teaching on these aspects.

2. A client who is receiving total parenteral nutrition (TPN) has an elevated blood glucose level. Which action should the nurse take first?

• A. Stop the TPN infusion.
• B. Administer insulin as prescribed.
• C. Notify the healthcare provider.
• D. Check the TPN infusion rate.

Correct answer: D

Rationale: The correct first action for a client receiving TPN with an elevated blood glucose level is to check the TPN infusion rate. Elevated blood glucose levels in clients receiving TPN can be due to incorrect infusion rates leading to increased glucose delivery. By checking the TPN infusion rate, the nurse can verify if the rate is appropriate and make necessary adjustments. Stopping the TPN infusion abruptly could lead to complications from sudden nutrient deprivation. Administering insulin as prescribed may be necessary but should come after ensuring the correct TPN infusion rate. Notifying the healthcare provider is important but addressing the immediate need to check the infusion rate takes priority to manage hyperglycemia effectively.

3. An older client requiring total care resides with a family consisting of two daughters who take shifts providing care around-the-clock. During a home visit, the daughters ask the nurse about resources that are available for client care while they attend a scheduled family reunion. Which information is best for the nurse to provide?

• A. propose the family seek assistance for care in the area of the reunion's location
• B. tell the caregivers to consider hiring a private duty nurse during the time away
• C. advise to have a case management evaluation of the client's home environment
• D. suggest social services be contacted to find a respite care facility for the client

Correct answer: D

Rationale: Respite care provides temporary relief for primary caregivers, allowing them to attend the reunion while ensuring the client is cared for.

4. The nurse is providing discharge teaching to a client with chronic obstructive pulmonary disease (COPD). Which statement by the client indicates a need for further teaching?

• A. I will use my albuterol inhaler before exercising.
• B. I will avoid secondhand smoke.
• C. I will get a flu shot every year.
• D. I will limit my fluid intake to 2 liters per day.

Correct answer: A

Rationale: Using an albuterol inhaler before exercising is appropriate for clients with COPD to prevent exercise-induced bronchospasm.

5. The healthcare provider provides teaching to a group of evacuees in a mass casualty center after a natural flooding disaster. Which information should the healthcare provider include in the teaching plan? (select one that does not apply.)

• A. wash all fruits and vegetables thoroughly in running tap water
• B. identify all sexual contacts since the evacuation process
• C. take all doses of prophylactic prescriptions for diarrhea
• D. clean hands using soap, clean water, or waterless antibacterial solutions

Correct answer: B

Rationale: In the aftermath of a flooding disaster, educating evacuees on proper hygiene practices like washing fruits and vegetables, taking prophylactic prescriptions, and practicing hand hygiene is crucial to prevent the spread of diseases. Option B, identifying sexual contacts, is not relevant to preventing post-disaster health risks and should not be included in the teaching plan.

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