Nursing Elites

1. A client with hyperthyroidism is prescribed propranolol. The nurse understands that this medication is used to:

• A. Increase metabolism
• B. Reduce anxiety
• C. Decrease heart rate
• D. Increase blood pressure

Correct answer: C

Rationale: Propranolol is a beta-blocker commonly used in the management of hyperthyroidism. It works by blocking the effects of adrenaline, resulting in a decrease in heart rate and blood pressure. Choice A is incorrect because propranolol does not increase metabolism; instead, it may have a mild inhibitory effect. Choice B is incorrect as propranolol is not primarily used to reduce anxiety, although it may have some anxiolytic effects. Choice D is incorrect as propranolol actually decreases blood pressure by blocking the effects of adrenaline on the heart and blood vessels.

2. A nurse manager conducts evaluations with each staff member and reviews the staffing needs for the upcoming year. Which of the following best describes the behavior this manager is engaging in?

• A. Interpersonal activities
• B. Decisional activities
• C. Informational activities
• D. Transformational activities

Correct answer: B

Rationale: The correct answer is B: Decisional activities. A nurse manager conducting evaluations and reviewing staffing needs for the future involves making decisions related to resource allocation, planning, and problem-solving. These activities fall under the category of decisional activities in management. Choice A, Interpersonal activities, would involve activities like communicating, motivating, and leading staff. Choice C, Informational activities, would involve activities like gathering and disseminating information. Choice D, Transformational activities, would involve inspiring and motivating staff to achieve organizational goals through vision and change.

3. Nurse Ruth is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication?

• A. Tetany
• B. Hemorrhage
• C. Thyroid storm
• D. Laryngeal nerve damage

Correct answer: A

Rationale: The correct answer is 'Tetany.' Tetany is characterized by muscle twitching, tingling, and numbness, which are indicative of hypocalcemia. After a thyroidectomy, accidental removal or damage to the parathyroid glands can lead to decreased calcium levels, resulting in tetany. Choice B, 'Hemorrhage,' is incorrect as it typically presents with symptoms such as sudden swelling, increased pain, or drop in blood pressure. Choice C, 'Thyroid storm,' is incorrect as it involves a sudden exacerbation of hyperthyroidism, leading to symptoms like fever, tachycardia, and confusion. Choice D, 'Laryngeal nerve damage,' is incorrect as it would manifest with voice changes, difficulty swallowing, or respiratory distress, not the symptoms described in the scenario.

4. For the first 72 hours after thyroidectomy surgery, nurse Jamie would assess the female client for Chvostek's sign and Trousseau's sign because they indicate which of the following?

• A. Hypocalcemia
• B. Hypercalcemia
• C. Hypokalemia
• D. Hyperkalemia

Correct answer: A

Rationale: Chvostek's and Trousseau's signs are clinical manifestations that suggest hypocalcemia, a common complication following thyroidectomy. Chvostek's sign is elicited by tapping the facial nerve, resulting in facial muscle contraction, while Trousseau's sign is provoked by inflating a blood pressure cuff, leading to carpal spasm. Both signs are indicative of low calcium levels in the blood. Therefore, options B, C, and D are incorrect as they do not correlate with the signs specifically associated with hypocalcemia.

5. The client with newly diagnosed type 2 diabetes mellitus is being taught about self-care management. Which of the following statements indicates a need for further teaching?

• A. I will rotate my injection sites to prevent skin damage.
• B. I can stop taking my medication if my blood sugar is normal.
• C. I should monitor my blood sugar levels regularly.
• D. I should follow a healthy diet and exercise regularly.

Correct answer: B

Rationale: The correct answer is B. Clients with type 2 diabetes mellitus should not stop taking their medication even if blood sugar levels are normal. This is because ongoing management is necessary to control blood sugar levels and prevent complications. Choice A is correct as rotating injection sites helps prevent skin damage and improves insulin absorption. Choice C is correct as regular monitoring of blood sugar levels is vital for managing diabetes effectively. Choice D is correct as following a healthy diet and exercising regularly are key components of diabetes management.

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