Nursing Elites

1. A client with hypothyroidism is prescribed levothyroxine. The nurse should teach the client to take this medication:

• A. With meals
• B. Before bedtime
• C. On an empty stomach in the morning
• D. With a glass of milk

Correct answer: C

Rationale: Levothyroxine should be taken on an empty stomach in the morning to enhance absorption and efficacy. Taking it with meals (Choice A) may interfere with absorption due to food interactions. Taking it before bedtime (Choice B) can lead to difficulties with absorption and may disrupt the sleep cycle. Consuming levothyroxine with a glass of milk (Choice D) is not recommended as calcium in milk can interfere with its absorption. Therefore, the best practice is to take levothyroxine on an empty stomach in the morning to ensure optimal effectiveness.

2. A healthcare provider is educating a client with DM on recognizing symptoms of hypoglycemia. Which symptom should the healthcare provider mention?

• A. Increased thirst
• B. Frequent urination
• C. Sweating
• D. Weight loss

Correct answer: C

Rationale: The correct symptom to mention when educating a client with diabetes mellitus (DM) on hypoglycemia is sweating. Sweating is a common symptom of hypoglycemia as it occurs due to the activation of the sympathetic nervous system in response to low blood sugar levels. Increased thirst (Choice A) and frequent urination (Choice B) are more indicative of hyperglycemia (high blood sugar) rather than hypoglycemia. Weight loss (Choice D) is not a typical symptom associated with hypoglycemia.

3. The healthcare provider is assessing a client with suspected diabetes insipidus. Which of the following clinical manifestations would support this diagnosis?

• A. Polyuria and polydipsia
• B. Hypertension and bradycardia
• C. Weight gain and edema
• D. Oliguria and thirst

Correct answer: A

Rationale: Polyuria (excessive urination) and polydipsia (excessive thirst) are classic clinical manifestations of diabetes insipidus. In this condition, there is a deficiency of antidiuretic hormone, leading to the inability of the kidneys to concentrate urine effectively, resulting in increased urine output (polyuria) and consequent thirst (polydipsia). Hypertension and bradycardia (Choice B) are not typical findings in diabetes insipidus. Weight gain and edema (Choice C) are more indicative of conditions such as heart failure or nephrotic syndrome. Oliguria (decreased urine output) and thirst (Choice D) are contradictory symptoms to what is seen in diabetes insipidus.

4. A client with type 1 DM is experiencing hypoglycemia. Which symptom should the nurse expect to observe?

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

Correct answer: A

Rationale: The correct answer is A: Tachycardia. In hypoglycemia, the body releases adrenaline in response to low blood glucose levels, leading to symptoms such as tachycardia (rapid heart rate). Choice B, polyuria, refers to excessive urination and is not a typical symptom of hypoglycemia. Choice C, flushed skin, is not a common symptom of hypoglycemia; instead, pale skin and sweating are more characteristic. Choice D, dry mouth, is not directly associated with hypoglycemia; rather, it can be a symptom of hyperglycemia or dehydration.

5. A client with Cushing's syndrome is scheduled for surgery to remove an adrenal tumor. The nurse should monitor for which of the following complications postoperatively?

• A. Hyperglycemia
• B. Hypotension
• C. Hypokalemia
• D. Hyponatremia

Correct answer: B

Rationale: Postoperative hypotension is a common complication after adrenal tumor removal in a client with Cushing's syndrome. This occurs due to the sudden withdrawal of cortisol, which leads to a relative adrenal insufficiency state. Hyperglycemia (Choice A) is more common preoperatively due to excessive cortisol levels. Hypokalemia (Choice C) and Hyponatremia (Choice D) are also associated with Cushing's syndrome but are less likely to be immediate postoperative complications compared to hypotension.

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