Nursing Elites

1. Which atrioventricular heart block is also referred to as Mobitz II?

• A. Third-degree atrioventricular heart block
• B. Second-degree atrioventricular heart block
• C. First-degree atrioventricular heart block
• D. Complete heart block

Correct answer: B

Rationale: The correct answer is B. Second-degree atrioventricular heart block is also known as Mobitz II. In Mobitz II, some atrial impulses are blocked from reaching the ventricles, resulting in occasional dropped beats. Third-degree atrioventricular heart block is known as complete heart block, where no atrial impulses reach the ventricles. First-degree atrioventricular heart block is a condition where there is delayed conduction between the atria and ventricles but all atrial impulses are eventually conducted to the ventricles.

2. A client with diabetes experiences Somogyi's effect. To prevent this complication, the nurse should instruct the client to:

• A. Take insulin at 2:00 PM each day
• B. Engage in physical activity daily
• C. Increase the dose of regular insulin
• D. Eat a protein and carbohydrate snack at bedtime

Correct answer: D

Rationale: Somogyi effect, also known as rebound hyperglycemia, occurs as a response to nighttime hypoglycemia. Eating a protein and carbohydrate snack at bedtime can help prevent this by stabilizing blood sugar levels throughout the night. Instructing the client to take insulin at 2:00 PM each day (Choice A) may not directly address the nighttime hypoglycemia concern. Engaging in physical activity daily (Choice B) is generally beneficial for diabetes management but may not specifically prevent Somogyi's effect. Increasing the dose of regular insulin (Choice C) without addressing the nighttime hypoglycemia issue can exacerbate the problem.

3. Multifetal pregnancies with triplets occur at a rate of 1 in 8,100 births, but twins occur much more frequently with a rate of:

• A. 1 in 85 births.
• B. 1 in 5400 births.
• C. 1 in 2700 births.
• D. 1 in 540 births

Correct answer: A

Rationale: The correct answer is A: 1 in 85 births. The rate of twin pregnancies is approximately 1 in 85 births. This means that twins are more common compared to triplets, which occur at a rate of 1 in 8,100 births. Choices B, C, and D are incorrect because they do not reflect the correct frequency of twin pregnancies as stated in the question.

4. A charge nurse making rounds observes that an assistive personnel (AP) has applied wrist restraints to a client who is agitated and does not have a prescription for restraints. Which of the following actions should the nurse take first?

• A. Remove the restraints from the client's wrists
• B. Review the chart for nonrestraint alternatives for agitation
• C. Speak with the AP about the incident
• D. Inform the unit manager of the incident

Correct answer: A

Rationale: The correct action for the nurse to take first is to remove the restraints from the client's wrists. Restraints should not be applied without a prescription due to the risk of harm to the client. Removing the restraints promptly is a priority to ensure the client's safety. Reviewing nonrestraint alternatives, speaking with the AP, and informing the unit manager can follow after ensuring the client's immediate safety by removing the restraints.

5. When reinforcing teaching and instructing the patient, which basic principle of teaching should you follow?

• A. Sequence the instruction from the least complex to the most complex.
• B. Assume that the patient knows little or nothing about the topic.
• C. Tell the patient to call their significant other so you can instruct them.
• D. Use medically oriented terms so the patient will be able to speak with the doctor.

Correct answer: A

Rationale: The correct principle of teaching to follow when reinforcing teaching and instructing the patient is to sequence the instruction from the least complex to the most complex. This approach facilitates learning by building upon simpler concepts before moving to more advanced ones. Choice B is incorrect because assuming the patient knows little or nothing about the topic may not always be accurate and can be patronizing. Choice C is incorrect as it does not focus on the direct teaching approach to the patient. Choice D is incorrect as using medically oriented terms may confuse the patient rather than facilitate understanding.

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