Nursing Elites

1. A client with diabetes mellitus is experiencing symptoms of hypoglycemia. The nurse should instruct the client to do which of the following?

• A. Eat a high-protein snack
• B. Consume 15 grams of simple carbohydrates
• C. Drink a glass of water
• D. Administer an extra dose of insulin

Correct answer: B

Rationale: Consuming 15 grams of simple carbohydrates is the recommended treatment for mild hypoglycemia to quickly raise blood sugar levels. Simple carbohydrates are rapidly absorbed and provide a quick source of glucose to combat low blood sugar. Eating a high-protein snack (Choice A) would delay the rise in blood sugar as proteins take longer to be broken down. Drinking water (Choice C) does not directly address the low blood sugar levels associated with hypoglycemia. Administering an extra dose of insulin (Choice D) would further lower blood sugar levels, worsening the hypoglycemic state.

2. A nurse manager conducts evaluations with each staff member and reviews the staffing needs for the upcoming year. Which of the following best describes the behavior this manager is engaging in?

• A. Interpersonal activities
• B. Decisional activities
• C. Informational activities
• D. Transformational activities

Correct answer: B

Rationale: The correct answer is B: Decisional activities. A nurse manager conducting evaluations and reviewing staffing needs for the future involves making decisions related to resource allocation, planning, and problem-solving. These activities fall under the category of decisional activities in management. Choice A, Interpersonal activities, would involve activities like communicating, motivating, and leading staff. Choice C, Informational activities, would involve activities like gathering and disseminating information. Choice D, Transformational activities, would involve inspiring and motivating staff to achieve organizational goals through vision and change.

3. A nurse manager in the emergency department considers policy changes in the organization and changes in the community, and tries to predict how these may impact the functioning of the unit. Which of the following decisional activities best describes this manager's actions?

• A. Resource allocation
• B. Monitoring
• C. Job analysis and redesign
• D. Planning for the future

Correct answer: D

Rationale: The correct answer is 'Planning for the future.' In this scenario, the nurse manager is engaging in strategic planning by considering policy changes and community dynamics to forecast potential impacts on the unit's functioning. This decisional activity involves anticipating future changes, challenges, and opportunities, and preparing the unit to adapt accordingly. Choice A, 'Resource allocation,' involves distributing resources effectively to support daily operations, which is not the primary focus of the nurse manager's actions described. Choice B, 'Monitoring,' typically involves overseeing current activities and performance to ensure adherence to standards and goals, rather than proactively planning for future changes as the nurse manager is doing. Choice C, 'Job analysis and redesign,' pertains to evaluating and modifying job roles and responsibilities within the unit, which is not directly related to the strategic forecasting and planning involved in anticipating organizational and community impacts.

4. The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following clinical manifestations should the nurse expect?

• A. Hypernatremia
• B. Hypotension
• C. Decreased urine output
• D. Polyuria

Correct answer: C

Rationale: The correct answer is C: 'Decreased urine output.' Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by excessive release of antidiuretic hormone, leading to water retention and decreased urine output. Therefore, the nurse should expect the client to have decreased urine output. Choices A, B, and D are incorrect. Hypernatremia (Choice A) is not typically associated with SIADH as it usually leads to dilutional hyponatremia. Hypotension (Choice B) is not a common clinical manifestation of SIADH. Polyuria (Choice D) is the opposite of what is expected in a client with SIADH, who typically presents with decreased urine output.

5. The client with Addison's disease is receiving education on managing the condition. Which of the following instructions should be included?

• A. Increase your sodium intake during periods of stress.
• B. Avoid all types of exercise.
• C. Decrease your fluid intake to prevent fluid overload.
• D. Stop corticosteroid therapy once symptoms improve.

Correct answer: A

Rationale: The correct instruction to include for a client with Addison's disease is to increase sodium intake during periods of stress. In Addison's disease, there is a deficiency of aldosterone leading to sodium loss. Increasing sodium intake helps to compensate for this loss and prevent complications. Choice B is incorrect as exercise is beneficial for overall health but should be done in moderation. Choice C is incorrect as fluid intake should be adequate to prevent dehydration since clients with Addison's disease are prone to electrolyte imbalances. Choice D is incorrect as corticosteroid therapy is essential for managing Addison's disease and should not be discontinued abruptly without medical guidance.

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