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A nurse is assessing a client's readiness to learn about insulin self-administration. Which of the following statements should the nurse identify as an indication that the client is ready to learn?
- A. "I can concentrate best in the morning."
- B. "It is difficult to read the instructions because my glasses are at home."
- C. "I'm wondering why I need to learn this."
- D. "You will have to talk to my partner about this."
Correct Answer: D
Rationale: The correct answer is D because it shows the client is willing to involve their partner in the learning process, indicating readiness for education. Involving a partner can enhance support and understanding, leading to better adherence. A: Time preference does not directly relate to readiness to learn about insulin. B: Difficulty reading instructions due to glasses is a practical issue, not an indicator of readiness. C: Expressing doubt or questioning the necessity of learning indicates potential resistance or lack of motivation.
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Which nursing action can the nurse delegate to unlicensed assistive personnel (UAP) working in the diabetic clinic?
- A. Measure the ankle-brachial index.
- B. Check for changes in skin pigmentation.
- C. Assess for unilateral or bilateral foot drop.
- D. Ask the patient about symptoms of depression.
Correct Answer: A
Rationale: The correct answer is A, "Measure the ankle-brachial index." This task involves using a blood pressure cuff and Doppler ultrasound to assess blood flow in the lower extremities, which is within the scope of practice for UAPs. It is a non-invasive procedure that does not require specialized training.
Choice B, "Check for changes in skin pigmentation," involves assessing for potential skin changes related to circulation issues, which requires more in-depth knowledge and interpretation than what UAPs are trained for.
Choice C, "Assess for unilateral or bilateral foot drop," involves evaluating muscle strength and nerve function, which requires clinical judgment and knowledge beyond the scope of UAP practice.
Choice D, "Ask the patient about symptoms of depression," involves assessing mental health and requires communication skills and training that UAPs do not typically have.
When lifting a bedside cabinet to move it closer to a client, what action should the nurse take to prevent self-injury?
- A. Keep the feet close together.
- B. Use the back muscles for lifting.
- C. Stand close to the cabinet when lifting it.
- D. Bend at the waist.
Correct Answer: A
Rationale: The correct answer is A: Keep the feet close together. This helps maintain a stable base of support, improving balance and reducing the risk of injury. The wider the base of support, the more stable the body is during lifting. Keeping the feet close together also helps distribute the weight evenly and allows for better control over the movement.
Summary of why other choices are incorrect:
B: Using the back muscles for lifting can lead to strain and injury. It is important to use the legs and core muscles instead.
C: Standing close to the cabinet when lifting may cause strain due to limited range of motion. It is better to maintain a comfortable distance.
D: Bending at the waist increases the risk of back injury. Instead, it is recommended to bend at the knees and hips while keeping the back straight.
Which type of HMO contracts with two or more IPAs (Independent Practice Associations)?
- A. Staff model
- B. Point of service model
- C. Network model
- D. Group model
Correct Answer: C
Rationale: The correct answer is C: Network model. In this model, the HMO contracts with multiple IPAs, allowing members to choose from a wider network of physicians. This promotes flexibility and choice. The other choices are incorrect because:
A: Staff model involves directly employing physicians, not contracting with IPAs.
B: Point of service model allows members to go outside the network for care, not necessarily contracting with IPAs.
D: Group model involves physicians working in a group practice, not IPAs.
The nurse manager can use several strategies to improve communication when giving directions. Asking the subordinate to repeat the instructions would be which of the following strategies?
- A. Verifying through feedback
- B. Follow-up communication
- C. Getting positive attention
- D. Knowing the context of the instruction
Correct Answer: A
Rationale: The correct answer is A: Verifying through feedback. This strategy involves ensuring that the message was accurately received and understood by asking the subordinate to repeat the instructions. This helps confirm clarity and reduces the chances of miscommunication or errors. It promotes active listening and engagement, enhancing communication effectiveness.
Summary:
B: Follow-up communication is about checking in after the initial communication, not verifying understanding in the moment.
C: Getting positive attention is unrelated to verifying understanding of directions.
D: Knowing the context of the instruction is important but not the same as verifying understanding through feedback.
1. Which patient action indicates good understanding of the nurse’s teaching about
administration of aspart (NovoLog) insulin?
- A. The patient avoids injecting the insulin into the upper abdominal area
- B. The patient cleans the skin with soap and water before insulin administration.
- C. The patient stores the insulin in the freezer after administering the prescribed dose.
- D. The patient pushes the plunger down while removing the syringe from the injection site
Correct Answer: B
Rationale: The correct answer is B because cleaning the skin with soap and water before insulin administration helps prevent infection. Proper skin preparation is essential for safe injection practices. Choice A is incorrect because the abdominal area is a recommended site for insulin injection. Choice C is incorrect because insulin should not be stored in the freezer. Choice D is incorrect because pushing the plunger down while removing the syringe could result in incomplete dosing.