Nokea
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: The correct answer is C because stating "I can choose any foods, as long as I use enough insulin to cover the calories" shows a lack of understanding of diabetes management. In type 1 diabetes, it's crucial to follow a balanced diet to regulate blood sugar levels. Choosing any foods without considering their impact on blood sugar control can lead to unstable glucose levels.
Explanation for why the other choices are incorrect:
A: Choosing to have an occasional alcoholic drink if included in the meal plan is acceptable as long as it's done in moderation and accounted for in the overall diabetes management plan.
B: Needing a bedtime snack with NPH insulin is appropriate to prevent hypoglycemia overnight.
D: Eating something at meal times to prevent hypoglycemia, even if not hungry, is a good practice to maintain stable blood sugar levels.
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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. This recommendation helps regulate the body's internal clock, promoting a consistent sleep-wake cycle. By waking up at the same time every day, the client's body will naturally adjust and improve their ability to fall asleep at night. Watching TV in bed (A) can disrupt sleep due to the blue light emitted. Drinking hot cocoa (B) may not be ideal close to bedtime due to the caffeine content. Exercising before bed (D) can stimulate the body and make it harder to fall asleep.
Which of the following best describes the role of a nurse navigator?
- A. Provide direct patient care
- B. Coordinate complex care
- C. Assist with administrative tasks
- D. Manage clinical trials
Correct Answer: B
Rationale: The correct answer is B because a nurse navigator's role is to coordinate complex care for patients by guiding them through the healthcare system, connecting them with resources, and ensuring continuity of care. Providing direct patient care (A) is typically the responsibility of nurses, not nurse navigators. Assisting with administrative tasks (C) is more aligned with roles such as medical assistants or administrative staff. Managing clinical trials (D) involves research and regulatory responsibilities that are distinct from the care coordination focus of a nurse navigator. Therefore, the best description of a nurse navigator's role is coordinating complex care.
As a new nurse on a pediatric unit, you must work nights and you have minimal time to spend with your children. Your colleague observes that you speak abruptly with parents and you become easily annoyed when the patients cry or when they are demanding. You realize you are becoming increasingly more distressed and that you have no time with your children and, as a result you: (Select all that apply.)
- A. Express negative comments to colleagues about patients and parents who annoy you.
- B. Ask the nurse manager to have a schedule with an equal number of day and night shifts so that you can be with your children.
- C. Call off sick as frequently as you can without violating policies so that you have more time with your children.
- D. Minimize your communication with patients and parents so you do not offend them.
Correct Answer: B
Rationale: The correct answer is B because it addresses the root of the issue by requesting a schedule change that allows for a better work-life balance. This solution promotes your well-being and maintains professionalism.
A: Expressing negative comments is unprofessional and can create a toxic work environment. It does not address the underlying problem.
C: Calling off sick frequently is unethical and can compromise patient care. It does not address the issue at hand.
D: Minimizing communication with patients and parents is not appropriate as it goes against the principles of patient-centered care and can harm the therapeutic relationship.
A client is having difficulty breathing while receiving supplemental oxygen via a nasal cannula in a supine position. Which of the following interventions should the nurse take first?
- A. Suction the client's airway.
- B. Instruct the client to perform incentive spirometry every hour.
- C. Assist the client to an upright position.
- D. Humidify the client's supplemental oxygen.
Correct Answer: C
Rationale: The correct answer is C: Assist the client to an upright position. This is the priority intervention because placing the client in an upright position helps improve lung expansion and oxygenation by optimizing ventilation-perfusion matching. This position also reduces the risk of aspiration and improves overall respiratory function.
Choice A (Suction the client's airway) is not the first intervention because difficulty breathing in this scenario is more likely due to positioning rather than airway obstruction.
Choice B (Instruct the client to perform incentive spirometry every hour) is not the first intervention as it may not address the immediate issue of breathing difficulty related to supine positioning.
Choice D (Humidify the client's supplemental oxygen) is not the first intervention as lack of humidification is not likely the cause of the client's difficulty breathing in this situation.
Verbal interventions with an agitated patient may be calming. These interventions include:
- A. Holding and reassuring the patient
- B. Encouraging other staff to distract the patient
- C. Remaining calm and keeping an arm's distance
- D. Standing close to the patient while talking
Correct Answer: C
Rationale: The correct answer is C because remaining calm and keeping an arm's distance is crucial when dealing with an agitated patient. This approach helps prevent escalating the situation and promotes a sense of safety. Holding and reassuring the patient (A) can be perceived as intrusive and may escalate the agitation. Encouraging other staff to distract the patient (B) can also be counterproductive as it may increase the patient's distress. Standing close to the patient while talking (D) can be perceived as threatening and may escalate the situation further. Thus, maintaining calm and keeping a safe distance is the most effective verbal intervention strategy.