Nursing Elites

1. What are the complications of untreated Type 1 diabetes?

• A. Diabetic ketoacidosis and retinopathy
• B. Hypoglycemia and neuropathy
• C. Hypotension and kidney failure
• D. Infection and fluid overload

Correct answer: A

Rationale: Diabetic ketoacidosis and retinopathy are indeed common complications of untreated Type 1 diabetes. Diabetic ketoacidosis occurs when the body starts breaking down fat for fuel, leading to a dangerous buildup of ketones in the blood. Retinopathy refers to damage to the blood vessels of the retina due to high blood sugar levels over time. The other choices, hypoglycemia and neuropathy (choice B), hypotension and kidney failure (choice C), and infection and fluid overload (choice D) are not typically the primary complications associated with untreated Type 1 diabetes.

2. A nurse is working in an acute care mental health facility and is assessing a client who has schizophrenia. Which of the following findings should the nurse expect?

• A. All-or-nothing thinking.
• B. Euphoric mood.
• C. Disorganized speech.
• D. Hypochondriasis.

Correct answer: C

Rationale: The correct answer is C: Disorganized speech. Disorganized speech is a hallmark symptom of schizophrenia, characterized by impaired thought processes that lead to incoherent, disjointed communication. All-or-nothing thinking (Choice A) is more commonly associated with cognitive distortions seen in conditions like anxiety disorders. Euphoric mood (Choice B) is not a typical finding in schizophrenia, as individuals with this disorder often display a flat or blunted affect. Hypochondriasis (Choice D) involves a preoccupation with having a serious illness and is not a primary symptom of schizophrenia.

3. A nurse is preparing to apply a transdermal nicotine patch for a client. Which of the following actions should the nurse take?

• A. Shave hairy areas of skin prior to application.
• B. Wear gloves to apply the patch to the client's skin.
• C. Apply the patch within 1 hr of removing it from the protective pouch.
• D. Remove the previous patch and place it in a tissue.

Correct answer: B

Rationale: The correct answer is to wear gloves when applying the transdermal nicotine patch to prevent the nurse from absorbing nicotine through the skin. Choice A is incorrect because shaving hairy areas of skin is not necessary for applying a transdermal patch. Choice C is incorrect as transdermal patches should be applied immediately after removal from the protective pouch, not necessarily within 1 hour. Choice D is incorrect because the previous patch should be disposed of properly following institutional guidelines, not placed in a tissue.

4. How should a healthcare professional care for a patient with a central venous catheter?

• A. Monitor for infection and change the dressing regularly
• B. Ensure the catheter is patent and flush as needed
• C. Educate the patient on self-care and proper hygiene
• D. Monitor blood glucose levels and administer IV fluids

Correct answer: A

Rationale: Corrected Rationale: Regular monitoring for infection and dressing changes are essential aspects of caring for a patient with a central venous catheter. Infections are a significant risk with these catheters, so vigilant monitoring and timely dressing changes help prevent complications. Choice B is important too, but ensuring catheter patency and flushing are more focused on maintaining the functionality of the catheter rather than infection prevention. Choice C is also important for patient education, but the immediate concern for a healthcare professional is monitoring and preventing infections related to the catheter. Choice D is not directly related to the care of a central venous catheter.

5. An RN is making assignments for client care to an LPN at the beginning of the shift. Which of the following assignments should the LPN question?

• A. Assisting a client who is 24 hr postop to use an incentive spirometer
• B. Collecting a clean catch urine specimen from a client who was admitted on the previous shift
• C. Providing nasopharyngeal suctioning for a client who has pneumonia
• D. Replacing the cartridge and tubing on a PCA pump

Correct answer: D

Rationale: The LPN should question the assignment of replacing the PCA pump cartridge and tubing as it is outside the LPN's scope of practice. LPNs are not trained to handle tasks related to PCA pumps, which involve medication administration and monitoring that are typically within the RN's responsibilities. Assisting a postop client with an incentive spirometer (Choice A), collecting a clean catch urine specimen (Choice B), and providing nasopharyngeal suctioning for a client with pneumonia (Choice C) are all tasks that fall within the LPN's scope of practice and do not require questioning by the LPN.

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