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. Which of the following is a nursing issue of concern today?

• A. Safe staffing
• B. Low workloads
• C. Increasing professional autonomy
• D. Improving salaries

Correct answer: A

Rationale: The correct answer is A: Safe staffing. Safe staffing is a critical issue in nursing today due to its impact on patient outcomes and nurse well-being. While low workloads (choice B) may seem beneficial, they can also indicate understaffing, leading to burnout and compromising patient care. Increasing professional autonomy (choice C) is generally viewed positively as it empowers nurses, and improving salaries (choice D) is important but may not directly address patient safety concerns related to staffing levels.

3. What is the role of a nurse in a multidisciplinary healthcare team?

• A. Working independently without consulting others
• B. Coordinating patient care with other team members
• C. Ignoring patient concerns
• D. Making all healthcare decisions alone

Correct answer: B

Rationale: The correct answer is B: 'Coordinating patient care with other team members.' In a multidisciplinary healthcare team, nurses collaborate with other healthcare professionals to ensure comprehensive care for patients. Working independently without consulting others (choice A) is not aligned with the collaborative nature of multidisciplinary teams. Ignoring patient concerns (choice C) goes against the core principles of patient-centered care. Making all healthcare decisions alone (choice D) contradicts the teamwork approach of a multidisciplinary team.

4. Which individual is most at risk for Osgood-Schlatter disease?

• A. An elderly female who is hospitalized with a hip fracture and on bed rest
• B. A middle-aged male patient who has been exposed to asbestos in the shipping industry
• C. An adolescent who is physically active and the captain of their soccer team
• D. An infant of low birth weight and a gestational age of 28 weeks

Correct answer: C

Rationale: Osgood-Schlatter disease is a condition that commonly affects adolescents who are physically active, especially during growth spurts. It is caused by overuse of the knee, leading to inflammation of the patellar ligament at the tibial tuberosity. The repetitive stress on the growth plate during activities like running and jumping can trigger this condition. Therefore, an adolescent who is physically active and the captain of their soccer team is most at risk for Osgood-Schlatter disease. Choices A, B, and D are not at high risk for this condition as it is primarily seen in active adolescents.

5. A client with type 1 DM has a finger stick glucose level of 258mg/dl at bedtime. An order for sliding scale insulin exists. The nurse should:

• A. Call the physician
• B. Encourage the intake of fluids
• C. Administer the insulin as ordered
• D. Give the client ½ cup of orange juice

Correct answer: C

Rationale: In this scenario, the client with type 1 DM has a high glucose level at bedtime. The appropriate action for the nurse is to administer the sliding scale insulin as ordered. This insulin regimen is specifically designed to manage high blood glucose levels. Calling the physician is not necessary as the protocol for sliding scale insulin is already in place. Encouraging fluid intake or providing orange juice is not the correct intervention for addressing high blood glucose levels in this case.

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