Nursing Elites

1. What is the key management strategy for diabetic ketoacidosis (DKA)?

• A. Administer insulin
• B. Monitor blood glucose
• C. Administer IV fluids
• D. All of the above

Correct answer: D

Rationale: The key management strategy for diabetic ketoacidosis (DKA) involves a comprehensive approach that includes administering insulin to lower blood glucose levels, monitoring blood glucose levels to ensure they are within the target range, and administering IV fluids to correct dehydration and electrolyte imbalances. Choosing 'All of the above' as the correct answer is the most appropriate because all three interventions are essential components of DKA management. Administering insulin alone without addressing fluid status and monitoring blood glucose could lead to complications. Similarly, solely focusing on IV fluids or blood glucose monitoring without insulin administration would not effectively manage DKA.

2. The nurse is caring for a client following an acute myocardial infarction. The client is concerned that providing self-care will be difficult due to extreme fatigue. Which of the following strategies should the nurse implement to promote the client's independence?

• A. Request an occupational therapy consult to determine the need for assistive devices
• B. Assign assistive personnel to perform self-care tasks for the client
• C. Instruct the client to focus on gradually resuming self-care tasks
• D. Ask the client if a family member is available to assist with his care

Correct answer: C

Rationale: Instructing the client to focus on gradually resuming self-care tasks is the most appropriate strategy to promote independence while managing fatigue. This approach encourages the client to regain autonomy by engaging in self-care activities at their own pace. Requesting an occupational therapy consult (Choice A) may be beneficial but does not directly address the client's concern regarding fatigue and self-care. Assigning assistive personnel (Choice B) may hinder the client's independence by taking over tasks the client could potentially perform. Asking about family assistance (Choice D) does not empower the client to regain self-care abilities.

3. A nurse manager of a med surge unit is assigning care responsibilities for the oncoming shift. A client is waiting transfer back to the unit from the PACU following thoracic surgery. To which staff member should the nurse assign the client?

• A. Charge nurse
• B. RN
• C. LVN
• D. AP

Correct answer: B

Rationale: The correct answer is B: RN. An RN is required for managing post-surgical care in the immediate postoperative period, especially for a client following thoracic surgery. The RN is equipped with the necessary knowledge and skills to assess the client's condition, provide complex care, and recognize and respond to any complications that may arise. Assigning the client to the Charge nurse (A) may not be appropriate as the Charge nurse focuses more on administrative and managerial tasks rather than direct patient care. LVNs (C) and APs (D) may have limitations in their scope of practice when it comes to managing post-surgical care following thoracic surgery, which requires a higher level of assessment and intervention that an RN can provide.

4. A nurse is planning discharge teaching about cord care for the parents of a newborn. Which of the following instructions should the nurse plan to include in the teaching?

• A. Clean the base of the cord with hydrogen peroxide daily.
• B. The cord stump will fall off in 5 days.
• C. Contact the provider if the cord stump turns black.
• D. Keep the cord stump dry until it falls off.

Correct answer: D

Rationale: The correct answer is to keep the cord stump dry until it falls off. This is important to promote natural healing and prevent infection. Choice A is incorrect because cleaning the cord with hydrogen peroxide daily can actually delay healing and increase the risk of infection. Choice B is incorrect as the cord stump typically falls off within 1 to 3 weeks, not in 5 days. Choice C is incorrect because a cord stump turning black is a normal part of the healing process and does not necessarily indicate a problem requiring immediate provider contact.

5. What are the primary differences between Type 1 and Type 2 diabetes in terms of pathophysiology and treatment?

• A. Type 1: No insulin production; Type 2: Insulin resistance
• B. Type 1: Insulin resistance; Type 2: Insulin deficiency
• C. Type 1: Autoimmune; Type 2: Lifestyle-related
• D. Type 1: Insulin therapy; Type 2: Diet modification

Correct answer: A

Rationale: The correct answer is A. Type 1 diabetes is characterized by the absence of insulin production, while Type 2 diabetes involves insulin resistance. Choice B is incorrect because Type 1 diabetes is not related to insulin resistance. Choice C is inaccurate as Type 1 diabetes is autoimmune while Type 2 diabetes is more associated with lifestyle factors. Choice D is not correct since insulin therapy is primarily used in Type 1 diabetes, whereas diet modification is a common approach in managing Type 2 diabetes.

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