Nursing Elites

1. A client with diabetes mellitus visits a health care clinic. The client's diabetes was previously well controlled with glyburide (Diabeta), 5 mg PO daily, but recently the fasting blood glucose has been running 180-200 mg/dl. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?

• A. Prednisone (Deltasone)
• B. Atenolol (Tenormin)
• C. Phenelzine (Nardil)
• D. Allopurinol (Zyloprim)

Correct answer: A

Rationale: Prednisone, a corticosteroid, can increase blood glucose levels by promoting gluconeogenesis and decreasing glucose uptake by cells. This medication can lead to hyperglycemia in patients, especially those with diabetes mellitus. Atenolol (Tenormin) is a beta-blocker and is not known to significantly affect blood glucose levels. Phenelzine (Nardil) is a monoamine oxidase inhibitor used to treat depression and anxiety disorders; it does not typically impact blood glucose levels. Allopurinol (Zyloprim) is a xanthine oxidase inhibitor used to manage gout and does not interfere with blood glucose regulation.

2. Which of the following laboratory values should the nurse monitor in a client with Cushing's syndrome?

• A. Blood glucose levels
• B. Serum calcium levels
• C. Serum potassium levels
• D. Serum sodium levels

Correct answer: A

Rationale: The correct answer is A: Blood glucose levels. In Cushing's syndrome, there is excess cortisol in the body which leads to increased blood glucose levels due to its effect on glucose metabolism. Elevated blood glucose levels are a common finding in individuals with Cushing's syndrome. Monitoring blood glucose levels is crucial as it helps in assessing and managing hyperglycemia in these patients. Choice B, serum calcium levels, is not typically a priority in monitoring for Cushing's syndrome. While abnormalities in calcium levels can occur in some endocrine disorders, hypercalcemia is not a hallmark of Cushing's syndrome. Choice C, serum potassium levels, and Choice D, serum sodium levels, are not directly associated with Cushing's syndrome. While electrolyte imbalances can occur in various conditions, they are not specifically linked to Cushing's syndrome as blood glucose levels are.

3. The nurse is providing dietary instructions to a client with DM. The nurse instructs the client to include which item in the diet?

• A. High-fat foods
• B. Low-carbohydrate foods
• C. High-protein foods
• D. High-fiber foods

Correct answer: D

Rationale: High-fiber foods are beneficial for clients with diabetes because they help regulate blood glucose levels by slowing down the absorption of sugar. Additionally, high-fiber foods aid in maintaining satiety, supporting weight management, and preventing constipation. High-fat foods (choice A) are not recommended for clients with diabetes due to their potential negative impact on heart health and weight. While low-carbohydrate foods (choice B) can be part of a diabetes-friendly diet, high-fiber foods are more specifically beneficial for managing blood sugar levels. High-protein foods (choice C) can be included in moderation in a diabetic diet, but they are not the primary focus when it comes to improving glycemic control.

4. The healthcare provider is monitoring a client with Cushing's syndrome. Which of the following findings should be reported to the healthcare provider immediately?

• A. Hyperglycemia
• B. Hypertension
• C. Low-grade fever
• D. Weight gain

Correct answer: C

Rationale: In a client with Cushing's syndrome, a low-grade fever should be reported immediately as it may indicate an infection. Clients with Cushing's syndrome are immunosuppressed, making them more susceptible to infections. Hyperglycemia and hypertension are common findings in Cushing's syndrome and are managed as part of the condition. Weight gain is also a common symptom in Cushing's syndrome and may not require immediate reporting unless it is sudden and severe.

5. Nurse Louie is developing a teaching plan for a male client diagnosed with diabetes insipidus. The nurse should include information about which hormone lacking in clients with diabetes insipidus?

• A. Antidiuretic hormone (ADH)
• B. Thyroid-stimulating hormone (TSH)
• C. Follicle-stimulating hormone (FSH)
• D. Luteinizing hormone (LH)

Correct answer: A

Rationale: Diabetes insipidus is a condition characterized by a deficiency of antidiuretic hormone (ADH). ADH plays a crucial role in regulating water balance by controlling the amount of water reabsorbed by the kidneys. Options B, C, and D are incorrect as they are not associated with diabetes insipidus. TSH (thyroid-stimulating hormone) is responsible for regulating thyroid function, while FSH (follicle-stimulating hormone) and LH (luteinizing hormone) are involved in reproductive functions.

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