Nursing Elites

1. A 60-year-old man presents with fatigue, polyuria, and polydipsia. Laboratory tests reveal hyperglycemia and ketonuria. What is the most likely diagnosis?

• A. Type 1 diabetes mellitus
• B. Type 2 diabetes mellitus
• C. Diabetes insipidus
• D. Hyperthyroidism

Correct answer: A

Rationale: The presentation of a 60-year-old man with fatigue, polyuria, polydipsia, hyperglycemia, and ketonuria strongly suggests type 1 diabetes mellitus. Type 1 diabetes typically presents with acute symptoms due to absolute insulin deficiency, leading to hyperglycemia and ketonuria. Conversely, type 2 diabetes often presents more insidiously and is associated with relative insulin deficiency and insulin resistance. Diabetes insipidus, a condition characterized by excessive thirst and excretion of large amounts of dilute urine, is due to problems with antidiuretic hormone (ADH) and is not associated with hyperglycemia or ketonuria. Hyperthyroidism, while also presenting with symptoms like fatigue, does not typically manifest with hyperglycemia or ketonuria. Therefore, based on the clinical presentation and laboratory findings, the most likely diagnosis in this case is type 1 diabetes mellitus.

2. A patient with heart failure is prescribed digoxin. What is the most important instruction the nurse should provide?

• A. Take an extra dose if you miss one.
• B. Avoid high-potassium foods.
• C. Report any visual disturbances.
• D. Stop taking the medication if your pulse is normal.

Correct answer: C

Rationale: The correct answer is C: 'Report any visual disturbances.' Patients taking digoxin should be instructed to report any visual disturbances, as this can be a sign of digoxin toxicity. Visual disturbances like changes in color vision, blurred vision, or seeing halos around lights can indicate an overdose of digoxin. Choices A, B, and D are incorrect. Instructing a patient to take an extra dose if they miss one can lead to overdose. Avoiding high-potassium foods is important for patients on potassium-sparing diuretics, not digoxin. Stopping the medication if the pulse is normal is incorrect, as the pulse rate alone is not an indicator of digoxin effectiveness or toxicity.

3. A client who is acutely ill has vigilant oral care included in their plan of care. What factor increases this client's risk for dental caries?

• A. Hormonal changes induced by the stress response leading to an acidic oral environment
• B. Systemic infections commonly affecting the teeth
• C. Intravenous hydration lacking fluoride
• D. Inadequate nutrition and reduced saliva production contributing to cavities

Correct answer: D

Rationale: Inadequate nutrition and decreased saliva production can lead to a conducive environment for the development of dental caries. Without proper nutrition and sufficient saliva, the protective mechanisms against cavities are compromised, making the individual more susceptible to tooth decay.

4. A patient with systemic lupus erythematosus (SLE) is prescribed hydroxychloroquine. What is the most important instruction the nurse should give?

• A. Report any vision changes immediately.
• B. Take the medication with milk.
• C. Avoid high-fat foods.
• D. Increase intake of green leafy vegetables.

Correct answer: A

Rationale: The correct instruction for a patient prescribed hydroxychloroquine, especially in the context of systemic lupus erythematosus (SLE), is to report any vision changes immediately. Hydroxychloroquine can potentially cause retinal damage, so prompt reporting and ophthalmologic evaluation are essential in preventing irreversible eye complications. Choices B, C, and D are incorrect because they do not address the significant adverse effect of hydroxychloroquine on vision. Taking the medication with milk, avoiding high-fat foods, or increasing intake of green leafy vegetables are not relevant to the primary concern of monitoring for visual changes.

5. When providing dietary instructions to a client with cirrhosis, which dietary restriction is important for the nurse to emphasize?

• A. Low-protein diet
• B. Low-sodium diet
• C. High-fiber diet
• D. High-calcium diet

Correct answer: B

Rationale: A low-sodium diet is crucial for clients with cirrhosis to manage fluid retention and ascites. Excessive sodium intake can worsen fluid accumulation in the body, leading to complications. By restricting sodium intake, the client can help reduce fluid retention and maintain better overall health. Therefore, emphasizing a low-sodium diet is essential in the dietary management of cirrhosis. Choices A, C, and D are not the primary focus for cirrhosis management. While protein restriction may be necessary in advanced stages of liver disease, it is not the main dietary concern in cirrhosis. High-fiber and high-calcium diets are generally beneficial for overall health but are not specifically emphasized in cirrhosis management.

Similar Questions