Nursing Elites

1. What is the appropriate route of administration for insulin?

• A. Intramuscular
• B. Intradermal
• C. Subcutaneous
• D. Intravenous

Correct answer: C

Rationale: The appropriate route of administration for insulin is subcutaneous. Subcutaneous injections are commonly used for insulin administration due to the slower absorption rate compared to intramuscular or intravenous routes. This slower absorption rate allows for better control of blood glucose levels. Intramuscular administration is not ideal for insulin as it can lead to rapid absorption and fluctuations in blood sugar levels. Intradermal injections are shallow and used for skin testing rather than insulin administration. Intravenous administration of insulin is not recommended due to the rapid and unpredictable effects it can have on blood glucose levels.

2. Which natural body defense plays an active role in preventing infection?

• A. Yawning
• B. Body hair
• C. Hiccupping
• D. Rapid eye movements

Correct answer: B

Rationale: Body hair plays an active role in preventing infection by acting as a filter to block pathogens. It helps to prevent harmful substances from entering the body through the skin, providing a physical barrier against potential infections.

3. When providing discharge teaching for a group of clients, a nurse should recommend a referral to a dietitian for which client?

• A. A client who has a prescription for warfarin and states, 'I will need to limit how much spinach I eat.'
• B. A client who has gout and states, 'I can continue to eat anchovies on my pizza.'
• C. A client who has a prescription for spironolactone and states, 'I will reduce my intake of foods that contain potassium.'
• D. A client who has osteoporosis and states, 'I'll plan to take my calcium carbonate with a full glass of water.'

Correct answer: B

Rationale: The correct answer is the client who has gout and states, 'I can continue to eat anchovies on my pizza.' Gout is a condition that requires dietary modifications to manage symptoms. Anchovies are high in purines, which can exacerbate gout symptoms. Therefore, a referral to a dietitian is essential to provide appropriate dietary guidance for a client with gout. Clients on warfarin may need to monitor their vitamin K intake, particularly from foods like spinach. Clients taking spironolactone should be cautious about potassium-rich foods. Clients with osteoporosis should be educated on the proper administration of calcium supplements but do not necessarily need a dietitian referral for this specific statement.

4. For administering a cleansing enema, what is the common position typically used?

• A. Sims left lateral
• B. Dorsal Recumbent
• C. Supine
• D. Prone

Correct answer: A

Rationale: The correct position for administering a cleansing enema is the Sims left lateral position. This position is preferred as it helps to facilitate the procedure by allowing gravity to assist in the flow of the enema solution. The individual lies on their left side with the right knee flexed towards the chest, which helps to promote retention of the enema solution and its distribution throughout the colon. Choices B, C, and D are incorrect. The dorsal recumbent position (Choice B) is commonly used for physical examinations of the abdomen and genitalia. The supine position (Choice C) involves lying flat on the back and is not ideal for administering enemas. The prone position (Choice D) is lying flat on the stomach and is not suitable for administering enemas.

5. When caring for a client who speaks a language different from their own, what action should the nurse take?

• A. Request an interpreter of a different sex from the client.
• B. Request a family member or friend to interpret information for the client.
• C. Direct attention toward the interpreter when speaking to the client.
• D. Review the facility policy about the use of an interpreter.

Correct answer: D

Rationale: When caring for a client who speaks a different language, it is essential for the nurse to review the facility policy about the use of an interpreter. Using a professional interpreter ensures accurate communication and protects the client's confidentiality. Requesting an interpreter of a specific sex or relying on family members or friends can lead to miscommunication or breaches of confidentiality. Directing attention towards the interpreter helps facilitate communication but does not address the need for a professional interpreter as per facility policy.

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