Nursing Elites

1. A client with hyperthyroidism is being treated with radioactive iodine. The nurse should teach the client to expect which of the following side effects?

• A. Increased heart rate
• B. Hypothyroidism
• C. Hypercalcemia
• D. Weight loss

Correct answer: B

Rationale: When a client with hyperthyroidism undergoes radioactive iodine treatment, it often leads to hypothyroidism due to the destruction of thyroid tissue. This occurs as a desired outcome of the treatment to reduce the overactive thyroid function. Choices A, C, and D are incorrect. Increased heart rate, hypercalcemia, and weight loss are not expected side effects of radioactive iodine treatment for hyperthyroidism. Instead, the goal is to suppress the overactive thyroid, leading to a hypothyroid state.

2. The nurse and an unlicensed nursing assistant are caring for a group of clients. Which nursing intervention should the nurse perform?

• A. Measure the client's output from the indwelling catheter.
• B. Record the client's intake and output on the I & O sheet.
• C. Instruct the client on appropriate fluid restrictions.
• D. Provide water for a client diagnosed with diabetes insipidus.

Correct answer: C

Rationale: Instructing the client on appropriate fluid restrictions is a nursing intervention that requires professional judgment and should be performed by the nurse. In this scenario, the nurse should provide education regarding fluid restrictions based on the client's individual needs. Measuring the client's output from the indwelling catheter (choice A) and recording intake and output (choice B) can be tasks delegated to the unlicensed nursing assistant. Providing water for a client diagnosed with diabetes insipidus (choice D) is not appropriate as these clients often require careful fluid management to prevent complications.

3. The client has syndrome of inappropriate antidiuretic hormone (SIADH). Which intervention is most appropriate?

• A. Encourage increased fluid intake
• B. Administer hypertonic saline
• C. Monitor for signs of dehydration
• D. Restrict oral fluids

Correct answer: D

Rationale: The correct intervention for a client with syndrome of inappropriate antidiuretic hormone (SIADH) is to restrict oral fluids. This is because SIADH leads to excessive production of antidiuretic hormone, causing water retention and dilutional hyponatremia. By restricting oral fluids, the nurse helps prevent further water retention and imbalance of electrolytes. Encouraging increased fluid intake (Choice A) would exacerbate the condition by further increasing fluid retention. Administering hypertonic saline (Choice B) is not the primary treatment for SIADH, as it may worsen the imbalance. Monitoring for signs of dehydration (Choice C) is not appropriate since SIADH leads to water retention, not dehydration.

4. Nurse Kate is providing dietary instructions to a male client with hypoglycemia. To control hypoglycemic episodes, the nurse should recommend:

• A. Increasing saturated fat intake and fasting in the afternoon
• B. Increasing intake of vitamins B and D and taking iron supplements
• C. Eating a candy bar if lightheadedness occurs
• D. Consuming a low-carbohydrate, high-protein diet and avoiding fasting

Correct answer: D

Rationale: A low-carbohydrate, high-protein diet is beneficial for individuals with hypoglycemia as it helps in maintaining stable blood sugar levels. Choice A is incorrect as increasing saturated fat intake and fasting can worsen hypoglycemia. Choice B is incorrect as vitamins and iron supplements do not directly address hypoglycemia. Choice C is incorrect as consuming a candy bar may provide temporary relief but does not address the underlying cause of hypoglycemia.

5. A healthcare professional is monitoring a client newly diagnosed with DM for signs of complications. Which sign or symptom, if exhibited in the client, indicates that the client is at risk for chronic complications of diabetes if blood glucose levels are not adequately managed?

• A. Polyuria
• B. Diaphoresis
• C. Pedal edema
• D. Proteinuria

Correct answer: D

Rationale: Proteinuria is the correct answer because it indicates kidney damage, which is a common complication of uncontrolled diabetes. Elevated blood glucose levels over time can damage the kidneys, leading to proteinuria. Polyuria (excessive urination) is a symptom of diabetes but does not specifically indicate a risk for chronic complications. Diaphoresis (excessive sweating) and pedal edema (swelling of the lower limbs) are not direct indicators of chronic complications related to uncontrolled diabetes.

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