Nursing Elites

1. A client with hyperparathyroidism is being assessed. Which of the following symptoms is the nurse likely to find?

• A. Tetany
• B. Hypocalcemia
• C. Bone pain
• D. Hypotension

Correct answer: C

Rationale: In hyperparathyroidism, there is excessive production of parathyroid hormone, leading to increased calcium resorption from the bones. This process causes bone pain, making choice C the correct answer. Tetany (choice A) is associated with hypocalcemia, not hyperparathyroidism. Hypocalcemia (choice B) is the opposite condition of hyperparathyroidism, where blood calcium levels are elevated. Hypotension (choice D) is not a typical symptom of hyperparathyroidism.

2. Skillful communication is one behavior of an effective leader. Which of the following describes an effective method of communication?

• A. A unit manager meets with a new nurse to discuss what is going well and what improvements the new nurse can make.
• B. A unit manager meets with a new nurse to explain departmental policy.
• C. A unit manager meets with staff after several safety events to unveil new policies designed to prevent further safety events.
• D. A unit manager describes safety events that have occurred on the unit to another nurse manager and discusses ideas for policy improvement with the other manager.

Correct answer: A

Rationale: Meeting with a new nurse to discuss progress and areas for improvement is an effective communication method.

3. The client with DM is being taught by the nurse about the importance of monitoring blood glucose levels. The nurse should instruct the client to:

• A. Check blood glucose only when feeling unwell.
• B. Check blood glucose before meals and at bedtime.
• C. Check blood glucose only after meals.
• D. Check blood glucose only in the morning.

Correct answer: B

Rationale: The correct answer is to check blood glucose before meals and at bedtime. Monitoring blood glucose levels before meals allows the client to adjust their insulin or oral antidiabetic medications based on their current levels. Checking at bedtime helps in ensuring blood glucose levels are at a safe range throughout the night. Option A is incorrect because blood glucose should be monitored regularly as part of diabetes management, not just when feeling unwell. Option C is incorrect because checking only after meals does not provide a complete picture of blood glucose control throughout the day. Option D is incorrect as checking only in the morning does not cover the full spectrum of blood glucose variations that can occur during the day.

4. A client with type 1 DM is experiencing signs of hypoglycemia. The nurse should expect which of the following symptoms?

• A. Tachycardia
• B. Polyuria
• C. Flushed skin
• D. Dry mouth

Correct answer: A

Rationale: In a client experiencing hypoglycemia, tachycardia is a common symptom. This occurs due to the release of adrenaline in response to low blood glucose levels, which stimulates the heart to beat faster. Polyuria, the increased production of urine, flushed skin, and dry mouth are not typical symptoms of hypoglycemia. Polyuria is more commonly associated with conditions like diabetes insipidus or uncontrolled diabetes mellitus. Flushed skin and dry mouth are not direct physiological responses to low blood sugar levels.

5. The nurse is caring for a client with Addison's disease. The client exhibits signs of hypotension, dehydration, and confusion. The nurse should anticipate administering which of the following medications?

• A. Insulin
• B. Hydrocortisone
• C. Levothyroxine
• D. Methimazole

Correct answer: B

Rationale: In Addison's disease, the adrenal glands do not produce enough cortisol. Hydrocortisone is a glucocorticoid medication that is used to replace deficient cortisol levels in patients with Addison's disease. It helps stabilize blood pressure and fluid balance. Insulin (Choice A) is used to manage diabetes, not Addison's disease. Levothyroxine (Choice C) is a thyroid hormone replacement used to treat hypothyroidism, not Addison's disease. Methimazole (Choice D) is used in the treatment of hyperthyroidism, not Addison's disease.

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