Nursing Elites

1. The nurse determines a need for additional instruction when the patient with newly diagnosed type 1 diabetes says which of the following?

• A. “I can have an occasional alcoholic drink if I include it in my meal plan.”
• B. “I will need a bedtime snack because I take an evening dose of NPH insulin.”
• C. “I can choose any foods, as long as I use enough insulin to cover the calories.”
• D. “I will eat something at meal times to prevent hypoglycemia, even if I am not hungry.”

Correct answer: C

Rationale:

2. The nurse identifies a need for additional teaching when the patient who is self-monitoring blood glucose

• A. washes the puncture site using warm water and soap
• B. chooses a puncture site in the center of the finger pad
• C. hangs the arm down for a minute before puncturing the site
• D. says the result of 120 mg indicates good blood sugar control

Correct answer: B

Rationale: The correct answer is B because choosing a puncture site in the center of the finger pad is not recommended for blood glucose monitoring. The recommended sites are the sides of the fingertips. Option A is correct as washing the puncture site using warm water and soap is a good practice. Option C is also correct as hanging the arm down for a minute can help increase blood flow. Option D is incorrect as a blood sugar level of 120 mg/dL may not necessarily indicate good blood sugar control and needs further interpretation.

3. Which action by a patient indicates that the home health nurse’s teaching about glargine and regular insulin has been successful?

• A. The patient administers the glargine 30 minutes before each meal
• B. The patient’s family prefills the syringes with the mix of insulins weekly.
• C. The patient draws up the regular insulin and then the glargine in the same syringe.
• D. The patient disposes of the open vials of glargine and regular insulin after 4 weeks

Correct answer: D

Rationale:

4. After the nurse has finished teaching a patient who has a new prescription for exenatide (Byetta), which patient statement indicates that the teaching has been effective?

• A. “I may feel hungrier than usual when I take this medicine.”
• B. “I will not need to worry about hypoglycemia with the Byetta.”
• C. “I should take my daily aspirin at least an hour before the Byetta.”
• D. “I will take the pill at the same time I eat breakfast in the morning.”

Correct answer: C

Rationale:

5. A nurse is caring for a client who reports difficulty falling asleep. Which of the following recommendations should the nurse make?

• A. Watch a television program in bed before going to sleep.
• B. Drink a cup of hot cocoa before bedtime.
• C. Maintain a consistent time to wake up each day.
• D. Exercise 1 hour before going to bed.

Correct answer: C

Rationale: The correct answer is C: "Maintain a consistent time to wake up each day." Establishing a regular wake-up time helps regulate the body's internal clock and promotes better sleep patterns. Watching television in bed (Choice A) can actually hinder sleep due to the light emitted by screens affecting melatonin production. Drinking beverages with caffeine like hot cocoa (Choice B) close to bedtime can interfere with falling asleep. Exercising vigorously right before bed (Choice D) can increase alertness and make it harder to fall asleep.

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