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. A nursing student needs to administer potassium chloride intravenously as prescribed to a client with hypokalemia. The nursing instructor determines that the student is unprepared for this procedure if the student states that which of the following is part of the plan for preparation and administration of the potassium?

• A. Obtaining a controlled IV infusion pump
• B. Monitoring urine output during administration
• C. Diluting an appropriate amount of normal saline
• D. Preparing the medication for bolus administration

Correct answer: D

Rationale: The correct answer is preparing the medication for bolus administration (Choice D). Potassium should never be administered as a bolus because it can cause cardiac arrest. It must always be diluted and given slowly. Obtaining a controlled IV infusion pump (Choice A) is essential for accurate delivery, monitoring urine output during administration (Choice B) helps assess the client's response, and diluting an appropriate amount of normal saline (Choice C) is necessary to prevent irritation and ensure safe administration.

3. The nurse is caring for a client with DM who is experiencing ketoacidosis. The nurse should prioritize which action?

• A. Administering insulin intravenously.
• B. Giving the client sips of water.
• C. Monitoring the client's urine output.
• D. Applying a heating pad to the client's abdomen.

Correct answer: A

Rationale: Administering insulin intravenously is the priority action for managing diabetic ketoacidosis. Insulin helps lower blood glucose levels and halts the production of ketones, addressing the underlying cause of ketoacidosis. Giving sips of water (Choice B) may be necessary for hydration, but it does not address the immediate life-threatening issue of ketoacidosis. Monitoring urine output (Choice C) is important for assessing renal function but is not the priority over administering insulin. Applying a heating pad (Choice D) is not indicated and can potentially worsen the condition in ketoacidosis.

4. A nurse manager is working to improve patient satisfaction on the unit. Which of the following best describes the nurse manager’s role in this process?

• A. The nurse manager should set clear expectations for patient satisfaction, monitor progress, and provide feedback to staff members to continuously improve patient care.
• B. The nurse manager should gather data on patient satisfaction, identify areas for improvement, and implement strategies to enhance the patient experience.
• C. The nurse manager should develop a patient satisfaction improvement plan, set measurable goals, and track progress over time to ensure continuous improvement.
• D. The nurse manager should involve patients and families in the patient satisfaction improvement process, gather feedback, and use it to make improvements to care delivery.

Correct answer: A

Rationale: The correct answer is A. The nurse manager's role in improving patient satisfaction involves setting clear expectations for patient satisfaction, monitoring progress, and providing feedback to staff members to continuously improve patient care. Choice B is incorrect as gathering data and implementing strategies are typically part of quality improvement initiatives but do not solely define the nurse manager's role. Choice C is incorrect because the nurse manager is responsible for setting expectations and monitoring progress rather than developing the improvement plan. Choice D is incorrect as involving patients and families and gathering feedback are important aspects, but the question specifically asks about the nurse manager's role, which primarily involves setting expectations, monitoring progress, and providing feedback to staff.

5. A patient with acute congestive heart failure is receiving high doses of a diuretic. On assessment, the nurse notes flat neck veins, generalized muscle weakness, and diminished deep tendon reflexes. Suspecting hyponatremia, what additional signs would the nurse expect to note in this patient if hyponatremia were present?

• A. Dry skin
• B. Decreased urinary output
• C. Hyperactive bowel sounds
• D. Increased specific gravity of the urine

Correct answer: C

Rationale: In a patient with hyponatremia, hyperactive bowel sounds are expected due to increased gastrointestinal motility. Dry skin (Choice A) is not a typical sign of hyponatremia. Decreased urinary output (Choice B) is more commonly associated with conditions like dehydration or renal issues, not specifically hyponatremia. Increased specific gravity of the urine (Choice D) is a sign of concentrated urine, which is not a characteristic finding in hyponatremia.

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