Nursing Elites

1. Which of the following methods of insulin administration would be used in the initial treatment of hyperglycemia in a client with diabetic ketoacidosis?

• A. Subcutaneous
• B. Intramuscular
• C. IV bolus only
• D. IV bolus, followed by continuous infusion

Correct answer: D

Rationale: The correct answer is D: IV bolus, followed by continuous infusion. In the initial treatment of hyperglycemia in a client with diabetic ketoacidosis, insulin is administered via IV bolus to quickly reduce blood glucose levels, followed by a continuous infusion to maintain control. Subcutaneous and intramuscular routes are not used in this situation as they are not rapid or predictable enough to address the acute hyperglycemia seen in diabetic ketoacidosis. IV bolus alone without the continuous infusion may not provide sustained control of blood glucose levels, making choice C incorrect.

2. Why is patient confidentiality significant in healthcare?

• A. Sharing patient information freely
• B. Protecting patient privacy
• C. Ignoring patient consent
• D. Limiting patient access to their own records

Correct answer: B

Rationale: Patient confidentiality is significant in healthcare because it involves protecting patient privacy. Maintaining confidentiality ensures that patients feel safe and secure when sharing sensitive information with healthcare providers. Choice A is incorrect because sharing patient information freely would violate confidentiality. Choice C is incorrect because ignoring patient consent goes against ethical principles. Choice D is incorrect because limiting patient access to their own records does not relate directly to the concept of patient confidentiality.

3. Most water leaves the body by way of the:

• A. Lungs
• B. Intestines
• C. Skin
• D. Kidneys

Correct answer: D

Rationale: Most water leaves the body through the kidneys. The kidneys play a crucial role in filtering waste and excess substances from the blood to form urine, which is then excreted out of the body. Choices A, B, and C are incorrect because while a small amount of water can be lost through respiration, feces, and sweating, the primary organ responsible for regulating water balance and excretion is the kidneys.

4. A nurse is caring for a client who requests information about the prevalence of Tay-Sachs disease. Which of the following resources should the nurse use to obtain this information?

• A. The client's health care provider
• B. A collaborative, user-edited website
• C. The facility's case manager
• D. An evidence-based nursing journal

Correct answer: D

Rationale: An evidence-based nursing journal is the correct choice for the nurse to obtain information about the prevalence of Tay-Sachs disease. These journals contain peer-reviewed research and studies conducted by experts in the field, providing accurate and reliable information. Choice A, the client's health care provider, may have general information but may not provide detailed prevalence data. Choice B, a collaborative, user-edited website, is not a reliable source as the information may be inaccurate or outdated. Choice C, the facility's case manager, is unlikely to have specific prevalence data on Tay-Sachs disease.

5. 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.

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