Nursing Elites

1. The client with newly diagnosed type 2 diabetes mellitus is being taught about self-care management. Which of the following statements indicates a need for further teaching?

• A. I will rotate my injection sites to prevent skin damage.
• B. I can stop taking my medication if my blood sugar is normal.
• C. I should monitor my blood sugar levels regularly.
• D. I should follow a healthy diet and exercise regularly.

Correct answer: B

Rationale: The correct answer is B. Clients with type 2 diabetes mellitus should not stop taking their medication even if blood sugar levels are normal. This is because ongoing management is necessary to control blood sugar levels and prevent complications. Choice A is correct as rotating injection sites helps prevent skin damage and improves insulin absorption. Choice C is correct as regular monitoring of blood sugar levels is vital for managing diabetes effectively. Choice D is correct as following a healthy diet and exercising regularly are key components of diabetes management.

2. A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the ER. Which finding would a nurse expect to note as confirming this diagnosis?

• A. Elevated blood glucose level and a low plasma bicarbonate
• B. Decreased urine output
• C. Increased respirations and an increase in pH
• D. Comatose state

Correct answer: A

Rationale: The correct answer is A: Elevated blood glucose level and a low plasma bicarbonate. Diabetic ketoacidosis (DKA) is characterized by hyperglycemia, ketosis, and metabolic acidosis, reflected by a low plasma bicarbonate. Elevated blood glucose levels are a hallmark of DKA due to the body's inability to use glucose properly. Choices B, C, and D are incorrect. Decreased urine output is not a specific finding associated with DKA. Increased respirations and an increase in pH are not typical in DKA; in fact, respiratory compensation for the metabolic acidosis in DKA leads to Kussmaul breathing (deep, rapid breathing). A comatose state may occur in severe cases of DKA but is not a confirming finding for the diagnosis.

3. The nurse is teaching a client with newly diagnosed hyperthyroidism about the management of the condition. Which of the following statements by the client indicates a need for further teaching?

• A. I should take my medication every day as prescribed.
• B. I need to avoid foods high in iodine.
• C. I can skip my medication on days when I feel fine.
• D. I should monitor my pulse regularly.

Correct answer: C

Rationale: Clients with hyperthyroidism should take their medication consistently and not skip doses, even if they feel well.

4. A client with type 1 DM calls the nurse to report recurrent episodes of hypoglycemia with exercise. Which statement by the client indicates an inadequate understanding of the peak action of NPH insulin and exercise?

• A. The best time for me to exercise is every afternoon.
• B. The best time for me to exercise is right after I eat.
• C. The best time for me to exercise is after breakfast.
• D. The best time for me to exercise is after my morning snack.

Correct answer: A

Rationale: Exercising in the afternoon may coincide with the peak action of NPH insulin, increasing the risk of hypoglycemia. The peak action of NPH insulin typically occurs 4-12 hours after administration, so exercising during this time can further lower blood sugar levels. Choices B, C, and D are better options as they suggest exercising at times that are less likely to overlap with the peak insulin action, reducing the risk of hypoglycemia.

5. Which of the following statements is true regarding followership and leadership?

• A. Effective leadership is more important than followership.
• B. Good leaders do not need to be good followers.
• C. A good follower is not just skilled but also self-directed.
• D. Critical thinking is only required for effective leadership.

Correct answer: C

Rationale: The correct answer is C: 'A good follower is not just skilled but also self-directed.' This statement is true as being self-directed complements effective leadership. Good followers possess the ability to take initiative, work independently, and contribute positively to a team without constant supervision. Option A is incorrect because followership is equally important as leadership in achieving group success. Option B is incorrect as good leaders often demonstrate qualities of good followership, such as being able to listen, collaborate, and support others. Option D is incorrect because critical thinking is essential for both effective leadership and followership, not exclusively for leadership roles.

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