Nursing Elites

1. A client with diabetes mellitus is receiving an oral antidiabetic medication. The nurse should monitor for which of the following adverse effects?

• A. Weight gain
• B. Hypoglycemia
• C. Hyperglycemia
• D. Bradycardia

Correct answer: B

Rationale: The correct answer is B: Hypoglycemia. When a client with diabetes mellitus is taking oral antidiabetic medication, the nurse should closely monitor for hypoglycemia, which is a common adverse effect. Hypoglycemia occurs when the blood sugar levels drop below normal range, leading to symptoms like confusion, shakiness, and sweating. Weight gain (Choice A) is not a typical adverse effect of oral antidiabetic medications. Hyperglycemia (Choice C) is the opposite of the desired effect of antidiabetic medications, which aim to lower blood sugar levels. Bradycardia (Choice D) is not directly associated with oral antidiabetic medications; it refers to a slow heart rate.

2. A client is admitted to the ER with DKA. In the acute phase, the priority nursing action is to prepare to:

• A. Administer regular insulin intravenously
• B. Administer 5% dextrose intravenously
• C. Correct the acidosis
• D. Apply an electrocardiogram monitor

Correct answer: A

Rationale: Administering regular insulin intravenously is the priority nursing action in the acute phase of DKA. Insulin helps to lower blood glucose levels by promoting cellular uptake of glucose and inhibiting ketone production. Administering dextrose would be counterproductive as it can worsen hyperglycemia. Correcting acidosis is important but usually follows insulin administration. Applying an electrocardiogram monitor is not the priority action in the acute management of DKA.

3. Nurse Ronn is assessing a client with possible Cushing's syndrome. In a client with Cushing's syndrome, the nurse would expect to find:

• A. Hypotension.
• B. Thick, coarse skin.
• C. Deposits of adipose tissue in the trunk and dorsocervical area.
• D. Weight gain in arms and legs.

Correct answer: C

Rationale: In Cushing's syndrome, the characteristic features include central obesity with deposits of adipose tissue in the trunk and dorsocervical area, often referred to as a 'buffalo hump.' Hypotension (Choice A) is not typically associated with Cushing's syndrome; instead, hypertension is more common. Thick, coarse skin (Choice B) is seen in conditions like hypothyroidism, not specifically in Cushing's syndrome. Weight gain in the arms and legs (Choice D) is not a typical finding in Cushing's syndrome; rather, weight gain is more prominent in the central areas of the body.

4. Which of the following statements is true regarding ethical principles and laws?

• A. The government enforces ethics.
• B. Laws establish standards that aid in decision-making.
• C. Ethics are highly specific.
• D. Ethical principles can serve as the foundation for laws.

Correct answer: D

Rationale: The correct answer is D. Ethical principles can influence the creation of laws but are not equivalent to laws themselves. Laws are established by governing bodies to provide a framework for society, whereas ethical principles guide individuals' moral conduct. Choice A is incorrect because governments enforce laws, not ethics. Choice B is incorrect as laws set legal standards rather than ethical ones. Choice C is incorrect because ethics are principles that guide behavior but are not necessarily highly specific.

5. The client has received IV solutions for three (3) days through a 20-gauge IV catheter placed in the left cephalic vein. On morning rounds, the nurse notes the IV site is tender to palpation and a red streak has formed. Which action should the nurse implement first?

• A. Start a new IV in the right hand.
• B. Discontinue the intravenous line.
• C. Complete an incident record.
• D. Place a warm washcloth over the site.

Correct answer: B

Rationale: The first action should be to discontinue the intravenous line to prevent further complications such as infection or thrombophlebitis. Starting a new IV in the right hand is not the priority as addressing the current issue is important. Completing an incident record can be done after addressing the immediate concern of the IV site. Placing a warm washcloth over the site does not address the red streak and tenderness, which may indicate an infection that requires discontinuation of the IV line.

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