Nursing Elites

1. Which of the following nursing interventions should be taken for a client who complains of nausea and vomits one hour after taking his glyburide (DiaBeta)?

• A. Administer glyburide again
• B. Administer subcutaneous insulin and monitor blood glucose
• C. Monitor blood glucose closely, and look for signs of hypoglycemia
• D. Monitor blood glucose and assess for signs of hyperglycemia

Correct answer: C

Rationale: After a client complains of nausea and vomits one hour after taking glyburide, the priority nursing intervention should be to monitor blood glucose closely and look for signs of hypoglycemia. Vomiting could indicate that the glyburide was not properly absorbed, potentially leading to hypoglycemia. Administering glyburide again (Choice A) could worsen hypoglycemia. Administering subcutaneous insulin (Choice B) is not appropriate without assessing the blood glucose first. Monitoring for signs of hyperglycemia (Choice D) is not the immediate concern in this situation.

2. The doctor has ordered 500 mg of a medication PO once a day. The tablets on hand are labeled as 1 tablet = 250 mg. How many tablets will you administer to your patient?

• A. 1 Tablet
• B. 2 Tablets
• C. 3 Tablets
• D. 4 Tablets

Correct answer: B

Rationale: To calculate the number of tablets needed, divide the total dosage prescribed (500 mg) by the dosage per tablet (250 mg per tablet). 500 mg / 250 mg per tablet = 2 tablets. Therefore, the correct answer is 2 tablets. Choices A, C, and D are incorrect as they do not accurately reflect the correct calculation based on the provided information.

3. 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.

4. A nurse is assisting with the orientation of a newly licensed nurse. The newly licensed nurse is having trouble focusing and has difficulty completing care for his assigned clients. Which of the following interventions is appropriate?

• A. Offer to provide care for his clients while he takes a break
• B. Advise him to complete less time-consuming tasks first
• C. Ask other staff members to take over some of his tasks
• D. Recommend that he take time to plan at the beginning of his shift

Correct answer: D

Rationale: The correct intervention is to recommend that the new nurse takes time to plan at the beginning of his shift. Planning ahead can help improve time management and focus. Option A is not ideal as it does not address the root cause of the issue and may not promote independence. Option B may not be effective if the nurse is struggling with time management in general. Option C involves shifting responsibilities to others without addressing the new nurse's need for improvement in managing his workload, which should be the priority.

5. Wilms' tumor is a form of:

• A. Renal cancer.
• B. Liver cancer.
• C. Basal cell carcinoma.
• D. Brain cancer.

Correct answer: A

Rationale: Wilms' tumor is a type of kidney cancer that primarily affects children. The correct answer is A: Renal cancer. This tumor originates in the kidneys and is most commonly found in children, with the peak incidence around 3-4 years of age. Choice B, Liver cancer, is incorrect as Wilms' tumor specifically involves the kidneys, not the liver. Choice C, Basal cell carcinoma, is a form of skin cancer, not related to Wilms' tumor. Choice D, Brain cancer, is incorrect as Wilms' tumor is not associated with the brain but rather with the kidneys.

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