Nursing Elites

1. Which information will the nurse include when teaching a 50-year-old patient who has type 2 diabetes about glyburide (Micronase, DiaBeta, Glynase)?

• A. Glyburide decreases glucagon secretion from the pancreas.
• B. Glyburide stimulates insulin production and release from the pancreas.
• C. Glyburide should be taken even if the morning blood glucose level is low.
• D. Glyburide should not be used for 48 hours after receiving IV contrast media.

Correct answer: B

Rationale: The correct answer is B: Glyburide stimulates insulin production and release from the pancreas. Glyburide belongs to the sulfonylurea class of antidiabetic medications, which work by stimulating the pancreas to produce and release more insulin. This helps to lower blood glucose levels. Choice A is incorrect because glyburide does not decrease glucagon secretion; instead, it acts on insulin. Choice C is incorrect because taking glyburide when blood glucose is low can lead to hypoglycemia. Choice D is incorrect as there is no specific interaction between glyburide and IV contrast media that requires avoiding its use for 48 hours.

2. When a client is receiving pain medication through a PCA pump, which of the following actions should the nurse take?

• A. Educate the family not to push the button for the client while the client is asleep.
• B. Explain to the client that vital signs will be monitored regularly due to being on a PCA pump.
• C. Instruct the client to push the button only when pain is above a 7 on a scale of 0 to 10.
• D. Adjust the basal rate and decrease the lock-out interval time if the client's pain level is too high.

Correct answer: D

Rationale: When a client is receiving pain medication through a PCA pump, it is essential to adjust the settings if their pain level is not adequately controlled. Increasing the basal rate and shortening the lock-out interval time can help manage the client's pain more effectively. This adjustment should be made by the healthcare provider based on the client's pain assessment and response to the current settings. It is crucial to individualize the PCA pump settings to optimize pain management for each client. Choices A, B, and C are incorrect because educating the family not to push the button, explaining vital sign monitoring, and setting a specific pain level for button pushing are not direct actions the nurse should take to adjust the PCA pump settings for effective pain management.

3. A 26-year-old patient with diabetes rides a bicycle to and from work every day. Which site should the nurse teach the patient to administer the morning insulin?

• A. Thigh
• B. Buttock
• C. Abdomen
• D. Upper arm

Correct answer: C

Rationale: The correct answer is the abdomen. When a patient engages in physical activities like riding a bicycle, the abdomen is a suitable site for insulin administration due to the consistent absorption rate. The subcutaneous tissue in the abdomen allows for more predictable insulin absorption compared to other sites. The thigh is also a common site for insulin injection but may not be ideal for this patient due to the physical activity involved. The buttock and upper arm are not preferred sites for insulin injection as they can have variable absorption rates and may not be as convenient for self-administration.

4. When addressing a policy violation, what is one of the initial steps to take?

• A. Terminate the employee.
• B. Confront the employee.
• C. Discipline the employee immediately.
• D. Determine whether the employee is aware of the policy.

Correct answer: D

Rationale: When addressing a policy violation, one of the initial steps should be to determine whether the employee is aware of the policy. This step allows for clarification, feedback, and potential training if needed. Terminating the employee (Choice A) or disciplining immediately (Choice C) without assessing awareness can lead to unfair treatment and legal issues. Confronting the employee (Choice B) may be necessary but should come after establishing awareness and providing necessary support or education.

5. Which of the following is an example of voluntary absenteeism?

• A. Staying home for a sick child
• B. Staying home for a funeral
• C. Staying home to run errands or finish housework
• D. Staying home for sickness

Correct answer: C

Rationale: The correct answer is C, 'Staying home to run errands or finish housework.' Voluntary absenteeism refers to absences that are within the employee's control. Running errands or completing housework are choices an employee makes, unlike being absent due to sickness or a funeral, which are events beyond the employee's control. Choices A, B, and D involve reasons for absence that are not voluntary as they are influenced by external circumstances, such as illness or family emergencies.

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