Nursing Elites

1. Which patient is at greatest risk for papilledema?

• A. An elderly patient with cataracts and macular degeneration
• B. A male patient with hypothyroidism
• C. A male patient with hyperthyroidism
• D. An adolescent with a closed head injury

Correct answer: D

Rationale: An adolescent with a closed head injury is at the highest risk for papilledema due to increased intracranial pressure. Papilledema is often a consequence of elevated intracranial pressure, which can occur in conditions like head trauma. Choices A, B, and C do not directly correlate with an increased risk of papilledema compared to a closed head injury, which is more likely to lead to elevated intracranial pressure and subsequent papilledema.

2. A nurse is preparing to discharge a client who requires home oxygen. The equipment company has not yet delivered the oxygen tank. Which of the following actions should the nurse take?

• A. Send an oxygen tank from the facility home with the client
• B. Instruct the client's family to contact the insurance provider about the oxygen equipment
• C. Contact social services about the delivery of the oxygen equipment
• D. Notify the provider about the delayed oxygen tank delivery

Correct answer: C

Rationale: The correct action for the nurse to take is to contact social services about the delivery of the oxygen equipment. This ensures that the necessary equipment is delivered to the client's home promptly. Choice A is incorrect because sending an oxygen tank from the facility is not a sustainable solution and may lead to legal and safety issues. Choice B is incorrect as contacting the insurance provider is not the appropriate course of action to address the delayed delivery. Choice D is also incorrect because notifying the provider about the delay may not directly lead to the timely delivery of the oxygen equipment.

3. Which of the following chronic complications is associated with diabetes?

• A. Dizziness, dyspnea on exertion, and coronary artery disease.
• B. Retinopathy, neuropathy, and coronary artery disease.
• C. Leg ulcers, cerebral ischemic events, and pulmonary infarcts.
• D. Fatigue, nausea, vomiting, muscle weakness, and cardiac arrhythmias.

Correct answer: B

Rationale: The correct answer is B. Diabetes is associated with chronic complications such as retinopathy, neuropathy, and coronary artery disease. Choice A includes symptoms rather than chronic complications of diabetes. Choice C lists conditions not typically associated with diabetes. Choice D describes symptoms that may occur in various medical conditions but are not specific chronic complications of diabetes.

4. 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.

5. A nurse manager is receiving report and is faced with the following situations that require intervention. Which of the following should the nurse manager address first?

• A. No transport assistance is available to take the client to PT.
• B. A client is refusing care from an AP of the opposite gender.
• C. Three staff members have called to say they will be absent.
• D. Two nurses had a heated disagreement about a scheduling issue.

Correct answer: C

Rationale: The correct answer is C. Addressing the absence of three staff members should be the nurse manager's priority as it directly impacts staffing levels and patient care. This situation can lead to staffing shortages, affecting patient safety and workload distribution. Option A, lack of transport assistance, although important, can be addressed after ensuring adequate staffing. Option B involves a client's preference and can be addressed by assigning care appropriately. Option D, a disagreement between two nurses, is important but can be addressed after ensuring adequate staffing and patient care.

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